Canine forelimb lameness Q&A highlights diagnostic blind spots

Forelimb lameness in dogs gets a practical diagnostic refresher in a new dvm360 Q&A featuring Leilani Alvarez, DVM, DACVSMR, CVA, CCRT, head of Integrative and Rehabilitative Medicine at the Schwarzman Animal Medical Center. In the February 26, 2026 interview, tied to her 2026 Veterinary Meeting & Expo lecture, Alvarez argues that canine forelimb cases are often harder to localize than hindlimb cases because dogs bear about 60% of body weight on the forelimbs, the shoulder relies heavily on soft-tissue support rather than bony attachment, and shoulder versus elbow pain can blur together into what some clinicians call the “shelbow.” She emphasizes a systematic workup built around observation, orthopedic and soft-tissue examination, neurologic assessment, and imaging to confirm the lesion. (dvm360.com)

Why it matters: For general practitioners, the message is less about a new test than about reducing missed localization and treatment delays in a very common presentation. Alvarez’s framework aligns with broader veterinary guidance that lameness evaluation should start with history, gait analysis, and a distal-to-proximal physical exam, while keeping neurologic disease and soft-tissue injury in the differential before moving to imaging such as radiography, ultrasound, CT, or MRI. That’s especially relevant in forelimb cases, where subtle soft-tissue injury, overlapping shoulder and elbow findings, and compensatory gait changes can make a rushed exam misleading. (dvm360.com)

What to watch: Expect more follow-on clinical education from dvm360 and conference speakers on structured forelimb workups, especially around when to escalate from radiographs to advanced imaging for suspected shoulder soft-tissue disease. (dvm360.com)