Can owners and clinicians assess outcome in dogs with fragmented medial coronoid process?

Objectives: To investigate the long term reliability of clinician and owner visual analogue score (VAS) for dogs with unilateral forelimb lameness attributable to fragmented medial coronoid process (FMCP) when compared to objective gait analysis.

Methods: Nine dogs with unilateral thoracic limb lameness due to FMCP underwent inverse dynamics gait analysis at initial presentation, and at one, two, six and 12 months following diagnosis. Total support moments were calculated and a total support moment ratio (TSMR) derived as an objective assessment of thoracic limb asymmetry. A VAS questionnaire for lameness was completed by the owner of each dog for each visit. Video footage of each dog walking and trotting at each visit was compiled, assigned to random order and subjected to VAS for lameness by a specialist in small animal surgery. Data from owner and clinician VAS lameness questionnaires were compared to the thoracic limb TSMR.

Results: Statistical analysis demonstrated a significant negative correlation between TSMR and owner VAS at four weeks post treatment but at no other period of evaluation. There was no significant correlation between TSMR and clinician VAS score at any evaluation period.

Clinical Significance: Assessments by owner and clinicians using VAS appear to be of limited use as a long term outcome measure for dogs with unilateral lameness due to FMCP when compared to objective gait analysis. There is a tendency for owners to underestimate forelimb lameness with increasing time which is not supported by quantitative measures of gait.