Muscle fibrosis in hind legs - care to share? - Page 1

Hi all,

I took my dog to the vet this morning and he has been diagnosed with muscle fibrosis in both hind legs. What has happened is that the muscle has shortened to such an extent that the cannot stretch his hing leg forward more than several centimeters. He is four years old. The vet says that this condition has an insidious development and is idiopathic in  nature. I actually felt the area and the muscle feels like bone. Anyhow he discussed some options (medicating and physiotherapy are not options) - the most successful of which is removing this affected muscle complex. He is going to phone me with all the stats etc. Now I am not doubting the diagnosis at all, but in the meantime I thought I'd find out if any other members of this database have experienced this. Have any of you and your dogs been through this procedure and can you let me know what your experiences were?

I look forward to hearing from you all.

Regards.
Vanessa

Vanessa:  with anything that serious I would, without a doubt, get a second opinion.  Removal of that muscle does ot sound like the thing to do but??  Surely there must be other options.  That is what you need to know from another source.  Best of luck  And is this a GSD??  Nan

Hi Nan,

Thank you for your feedback. This is the second opinion. The first vet I saw diagnosed muscle fibrosis in his left leg and a dysplastic right hip. He has A0 hips and I couldn't get my head around this diagnosis, which is why I sought a second opinion. The vet did say that, unfortunately, there are no drug or physiotherapy treatments for this condition. This does seem to be a rather rare condition.

Regards,
Vanessa

Well, I've done some investigating and found the following. I thought I'd share this with you all. Apparently this happens to about one in forty thousand GSDs a year (don't know how accurate this stat is).

(http://www.gsdhelp.info/neuro/fibroticmyopathy.html)
Fibrotic Myopathy is thought to be an uncommon acquired, disorder which probably occurs to some degree after any muscle contusion that heals primarily by scar tissue. The whole muscle or part of the muscle is replaced with fibrous connective tissue within the semitendinosus and, occasionally, the quadriceps muscles of the hindleg. When most or all of the traumatised muscle is replaced by fibrous scar tissue that contracts to an inelastic band, it is termed fibrotic myopathy or muscle contracture.
Affected animals are usually unable to extend the hip, knee (stifle) or ankle (hock) joints very well. So they walk short-strided and at the point that the leg should be in extension, it quickly pulls back up into flexion. Often the paw and knee will turn in a bit when flexion occurs. Increased angulation (flexion) at the stifle in normal German Shepherds may predispose these dogs to increased hamstring stress during physical activity. While onset in some dogs is acute (compatible with grade 2 or 3 muscle injury), the lameness appears to be insidious in most dogs (compatible with chronic or grade 1 muscle strain). Apart from semitendinosis and gracilis muscles, fibrous bands may occur in quadriceps muscles, biceps femoris, and semimembranosus in hind limbs, as well as in supraspinatus and infraspinatus muscles in dogs. A palpable band has also been found in the teres minor muscle. Duration of signs may range from weeks or several years.

Prognosis is guarded to poor since the condition in dogs tends to recur within several months following surgical resection, or transection, partial excision, or complete resection of the affected muscle to remove the fibrous band of tissue. Non-surgical treatment includes the managing any signs of pain and major uncoordination(e.g., the use of corticosteroids, non-steroidal inflammatory drugs, or acupuncture) but can be ineffective in many cases. Most dogs appear to have no pain once the disease process has reached its hight, but if the twist of the joint is far enough, these pets will have more trouble. Non-surgical rehabilitation, including therapeutic ultrasound and cross-fiber friction massage, may provide mild improvement in some dogs (slight increase in range of motion of the stifle and less crossing over of pelvic limbs). If fibrotic myopathy is causally related to muscle strain, appropriate preventive measures might include stretching, warm up exercises, and gradual build up to more intensive activities. Muscle contractures of the forelimb often respond better to treatment and carry a better prognosis than muscle contractures of the hindlimb.

I found a clip of a dog with the same condition that Jago has developed.
http://www.youtube.com/watch?v=sMdomjYNHmw

 Don't, I repeat, do not opt for surgery. Tendon fibrosis is usually caused by an auto immune action. One of my dogs developed it after an accident in which he tore out a rear nail. He was 5 years old. The limp or goose step did not begin for about 2 months after the accident, during which time he passed a schutzhund trial. When the limp came on, I immediately took him to my vet. We x-rayed him, hips were fine. He referred me to a specialist who identified the problem as fibrosis. He told me the condition could be likened to a rubber band which has a section which has wet cardboard in it which prevents the band from stretching. The specialist offered to do surgery.

I went to the University of Illinois Small Animal Clinic. After an extensive examination, three professors confirmed the specialists diagnosis of fibrosis. They offered to do surgery as well. However, they also ordered up the most recent research on fibrosis. Studies of fibrosis are extremely rare. When I went, about 1997, there had only been 19 documented cases world wide tracking dogs who had had surgery. The results---it always came back. Sometimes it took up to 5 or 6 months, but it ALWAYS CAME BACK. Always. Some of the dogs were operated on 2 or 3 more times and it still came back. Conclusion, surgery is not a permanent and hardly even a temporary solution.

But there is no need for surgery. Fibrosis is not life threatening. My dog went on to live to be 13+ and had fibrosis for 8 years. He was active until 3 weeks before his death when his hips gave out. 

I do not think that physical therapy is going to help either. But I do think that physical activity will make all the difference as to the quality of your dog's life and how long it lives. I walked my dog 5 days a week for 2 tow mile walk. I had to buy booties to protected the nails from bleeding and went through a heck of a lot of booties over the years. I put childrens socks on the paw before putting on the bootie and after a while, I started to duct tape the booties to make them last long. The Canadian Mutlucks are the best, stay on the best and last longer.  Also, if you have stairs, encourage your dog to go up and down them, just as before. Mine did without help until age 12. The last half year, he lived on the ground floor.

Another alternative exercise is swimming if you are able to find a pool or place where you dog can swim, this is even better than walking. However, I had no such place available. So walking worked just fine. He was able to run and jump (albeit not as good as before he had fibrosis) until he was 12 years old.

It is also very important to keep the weight off. Very important. You might also wish to consider supplements. I contacted Professor Roger Clemmons of the University of Florida Small Animal Clinic. He is one of the leading researchers on degenerative mylosis and talked about supplements. He recommended several including 400 mg of Vitamin E twice daily, 500mg of vitamin C twice daily, co-q10, glucosamin, chondroitin and MSM, grape seed and several others. He is online as are his supplement recommendations for DM. But fibrosis is not DM. Nonetheless, I gave supplements, including something called Wobenzyme, invented by 2 Columbia University scientists. Very good for old dogs and arthritis. I don't know if any of these things helped because I did not do any double blind studies, but I can tell you that they did not hurt, they caused no harm.

To sum up, I think of everything I did, the exercise (walking in my case) was the most important. Get yourself a good pair of shoes and good luck.

The dog in the video is mine. He was diagnosed with degenerative myleopathy, had had an MRI, and has been examined by 4 neurologists. 3 of 4 cannot find a cause, which indicates DM. The 4th, specializes in GSD DM and does genetic testing specific to the breed (not the same as the OFA recommended test) - says DM is 1% possible. This vet says it is likely fibrotic mylopathy. My dogs name is Duke. Duke is still walking, although less stable than the video. He bunny hops and cannot run. DM dogs have an average lifespan of 6 months after diagnosis and Duke is still here after more than a year. We walk every day and swim once per week. We have tried chiropractic for poor hips, with no result.... We were expecting a DM death sentance, so we are happy every day...

I'm so sorry about the diagnosis, but I'm glad that Duke is hanging in there. I've had my boy at the chiropractor too, and although there has been no real improvement to his legs, the doc was able to do some adjustments to his lower spine which has made him feel alot better.

Thank you so much for sharing your video and good luck with your boy.

Regards,
Vanessa 
 

klossbruhe...thank you, very detailed and very interesting post....good info to know.

I had a dog that was diagnosed as having DM by several vets.  Turns out that it was Fibrotic Myopathy - which was diagnosed by a sports oriented orthopedic vet.  They ruled out DM with a genetic test and put the dog on physical therapy.  This heavily involved me and I learned a lot of stretching exercises to do with the dog.  By eliminating the aggravators (such as releasing him from a platz for a ball when practicing go-outs), taking the PT, warming up properly before activity and stretching he recovered 50-75 percent of the range of motion he lost. 

I would absolutely NOT consider surgery one bit.  What can they do?  The muscle has lost it elasticity.  They can't put it back in and can only remove or shorten it even more.  It is also not pain causing.

-Calvin