JAMES L. COOK, DVM, PhD, Diplomate ACVS 1 and CRISTI R. COOK, DVM, MS, Diplomate ACVR 1 1 Comparative Orthopaedic Laboratory, University of Missouri, Columbia, MO Vet Surg 2009 Feb 38 2 224-232 ABSTRACT Objective—Characterize clinical findings and outcomes in dogs with forelimb lameness. Study Design—Prospective case series. Animals—Dogs (n=19) with forelimb lameness. Methods—Dogs were included when lameness was attributed to shoulder and/or elbow pathology with informed consent for bilateral shoulder and elbow arthroscopy. Historical, clinical examination and diagnostic imaging findings were recorded. Localization of lameness was determined and subjective arthroscopic assessment of shoulders and elbows performed. Outcomes were subjectively assessed by owner survey. Results—Dogs were lame in 1 (n=8) or both (11) forelimbs on admission. Lameness was localized to shoulders (8), elbows (6), or both (5). Preoperative localization was correct in 15 of 19 dogs (78.9%). Arthroscopic pathology was noted in 17 shoulders and 23 elbows. Orthopedic examination, spinatus muscle atrophy, abduction angles, elbow joint effusion, and radiographic assessment were clinically useful for preoperatively determining pathology. Eleven shoulders and 20 elbows were surgically treated. Dogs were significantly (P<.001) less lame at follow-up (mean±SD lameness score, 1.1±1.1) 6–24 months postoperatively compared with admission (4.2±2.8). Dogs with shoulder involvement only were significantly (P=.038) less lame than dogs with shoulder and elbow involvement after treatment. Most dogs (15) had mild to moderate lameness after treatment. Conclusion—Forelimb lameness in dogs may be associated with shoulder or elbow pathology or both. Preoperative localization and diagnosis based on examination, palpation, and radiography will be "correct"∼80% of the time. Clinical Relevance—We recommend comprehensive assessment using history, orthopedic examination, joint-specific palpation, radiography, and arthroscopy, and following outcomes to determine cause of lameness, indications for treatment, optimal treatment, and accurate client communication for forelimb lameness in dogs.