Overview

If your dog is limping or having trouble walking, it means something painful is interfering with the normal use of a limb. Lameness can range from mild stiffness to complete inability to bear weight and may involve muscles, joints, bones, or even the nervous system. Because dogs cannot tell us where it hurts, a thorough veterinary exam is essential to identify the source of pain and determine the best next steps for treatment and recovery.

Your veterinarian will work through the most likely causes based on your dog’s age, breed, size, history, clinical signs and exam findings. While some causes of lameness are straightforward, others require imaging, laboratory testing, or referral to a specialist. The goal is always to identify the source of pain so your dog can get back to comfortable, normal activity.

This guide walks you through what typically happens during a veterinary visit for a limping dog and what your veterinarian is thinking during the evaluation.

Before the exam

Your veterinarian will begin by asking detailed questions to better understand your dog's lameness, including:

• When the limping started and whether it came on suddenly or gradually
• Whether it is getting better, worse, or shifting between legs
• Any difficulty with stairs, jumping, rising from rest, or exercise
• Recent activity, trauma, or changes in routine
• Any medications your dog has received and whether they helped

Sometimes it is obvious which leg is affected, but other times multiple limbs may be involved. Some dogs also move normally once they arrive at the clinic due to excitement or adrenaline. Videos of your dog at home showing the limp are extremely helpful and can provide valuable information that isn’t visible during the exam.

Some dogs are anxious, painful, or uncomfortable in the clinic and may not tolerate a complete exam while awake. Your veterinarian will determine whether anti-anxiety medication or sedation is needed. While an awake exam is ideal for identifying pain responses, patient comfort and safety always come first.

The initial exam

Your veterinarian will perform a lameness examination, which focuses on two major systems:

• Musculoskeletal system (bones, joints, muscles, tendons, ligaments)
• Neurologic system (nerves and spinal cord)

Your veterinarian will observe how your dog walks and trots, watching for subtle changes in weight-bearing. Dogs instinctively shift weight away from painful limbs and onto healthier ones.

To make these changes easier to see, your veterinarian may:

• Watch your dog walk or trot on different surfaces
• Observe your dog walking in straight lines and in circles
• Pay close attention when your dog turns, since turning places more weight on the inside limbs

The orthopedic exam

While watching your dog move is an important first step, an orthopedic physical exam is essential for localizing pain. During this exam, your veterinarian will gently palpate (feel) your dog’s body to identify painful areas, swelling, instability, or reduced range of motion, akin to how your physician would examine you.

The exam typically includes:

• Palpation along the spine for pain or muscle tension
• Assessment for asymmetry, such as muscle loss or joint swelling
• Careful evaluation of each limb and joint, usually from the toe up to the hip or shoulder 

Highly athletic dogs may only show lameness during intense activity, making diagnosis more challenging. Very subtle lameness may require advanced diagnostics such as force plate analysis, which is typically available only at specialty or referral hospitals. In these cases, your primary care veterinarian may recommend referral to a specialist.

Diagnosis

In many cases, your veterinarian can identify the likely source of pain during their physical exam. In other cases, additional testing may be recommended to confirm a diagnosis, such as:

• X-rays (radiographs)
• Advanced imaging (CT or MRI)
• Bloodwork
• Joint fluid analysis (joint tap, or arthrocentesis)

Your veterinarian will discuss potential diagnoses, recommended tests, treatment options and cost estimates to help you make informed decisions.

Common causes of lameness 

When determining a cause for lameness, your veterinarian will consider the following to help narrow down possible causes of lameness:

• Size and breed: Large dogs are prone to different orthopedic conditions than small dogs.
• Age: Young dogs are more likely to have developmental conditions, while older dogs more commonly have degenerative, or wear-and-tear issues
• Limb affected: Front and hind limb lameness have different common causes

The lists below reflect common possibilities but are not exhaustive. More than one problem can exist at the same time, especially in older dogs.

Older dogs with hind limb lameness

Most common cause: Torn cranial cruciate ligament (similar to an ACL injury in people)

• Dogs may suddenly become unable to bear weight on the leg
• The knee joint may feel swollen or unstable 

Other causes:

• Hip arthritis
• Bone cancer (osteosarcoma)
• Spinal disease
• Foot injuries or infections

Older dogs with front limb lameness

Common causes:

• Elbow arthritis
• Shoulder conditions (arthritis, chronic soft tissue injuries)
• Neck or spinal problems causing nerve-related pain
• Bone cancer

Young dogs with hind limb lameness

Most common cause: Hip dysplasia (More common in larger breeds)

• Causes difficulty with stairs, jumping and getting into cars

Other causes:

• Panosteitis and hypertrophic osteodystrophy (“growing pains”)
• Luxating patella (kneecap dislocation)
• Tendon or muscle injuries 

Young dogs with front limb lameness

Common causes:

• Elbow dysplasia (developmental problems, especially in large breeds)
• Panosteitis and hypertrophic osteodystrophy
• Bone growth abnormalities (osteochondrosis)
• Shoulder conditions (developmental problems, tendon or muscle injuries)

Treatment 

Treatment for your dog’s lameness will depend on the underlying cause and may include:

• Pain control and non-steroidal anti-inflammatory medications (NSAIDs)
• Rest and activity restriction
• Weight management
• Physical rehabilitation
• Advanced sports medicine treatments such as stem cell therapy or platelet-rich plasma (PRP)
• Surgery or referral to a specialist, when indicated

The bottom line

If your dog has been limping for more than a day or two, or if the pain is severe, sudden or worsening, don’t wait. Early evaluation and treatment often lead to better comfort and an improved outcome for your dog.