Physical Examination and Workup
At this visit, after the onset of the limp, examination of the area near the right heel shows tenderness and some redness and swelling around the Achilles tendon. A gap can be palpated in the middle third of the Achilles tendon. The patient has weakness to resisted plantar flexion of the right ankle. She is asked to stand and support herself with her hands on the examination table. She is unable to raise her right heel to stand on her toes on the right side but can do so on the left. She is then asked to lie prone on the examination table; squeezing the left calf but not the right calf causes the ipsilateral ankle to plantar flex.
A walking boot is provided for the right leg. Six weeks later she starts physical therapy to improve her gait, increase ankle range of motion, and strengthen the calf muscles.
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Cite this: Anthony H. Woodward. Heel Pain and Limp in a Dog Owner Coughing Up Green Sputum - Medscape - Apr 19, 2023.