SymptomsSymptoms of dogs affected by Biceps Tendonitis typically have a history of chronic, progressive or intermittent, and moderate to severe weight-bearing lameness that worsens with exercise.
Breed SpecificBiceps Tendonitis is not specific to any one breed or sex. Furthermore, it has yet to be determined if it is more prevalent in the athletic dog, as opposed to the less active dog. Otherwise, as stated above, Biceps Tendonitis is a common cause of forelimb lameness in medium or large-sized dogs, as well as middle-aged or older dogs.
DiagnosisIn addition to a complete examination of the shoulder joint, a detailed neurologic examination may also be indicated, as conditions affecting the brachial plexus and cervical spinal cord often mimic shoulder pain.
Dogs generally bear weight on the affected limb because pain occurs only when the diseased tendon is gliding within the intertubercular groove. Muscle atrophy of the supraspinatus muscles over the spine of the scapula can be noticed. The degree of muscle atrophy is associated with the severity of the disease.
In addition to the physical examination, radiographic evaluation of the shoulder joint is also indicated. The special “skyline” positioning will require sedation of your pet. At this time, a joint tap may be recommended to rule out other causes of shoulder pain, such as septic arthritis or immune-mediated arthritis. Ultrasound can also be used to visualize the biceps tendon. In some cases, MRI is also recommended. Arthroscopy is also valuable in determining biceps tendonitis from medial shoulder instability.
Medical TreatmentThe primary objective of medical therapy is to reduce inflammation of the biceps tendon and sheath. Intraarticular injection of steroids into the shoulder joint has been advocated in the past. Direct injection of corticosteroids into the tendon, however, has been associated with collagen necrosis and tendon rupture and is, therefore, not recommended.
The use of systemic NSAID or corticosteroid therapy in the medical management of bicipital tenosynovitis has not been scientifically evaluated. Some reports show only about half of the pets treated with medical therapy respond. The use of anti-inflammatory medications, combined with physical rehabilitation that includes therapeutic ultrasound, has had some positive effects.