Biceps Tenotomy in Dogs

The two tendons of the arm that meet at the shoulder are known as bicep tendons. These tendons control movement in the forelimbs of a dog. When these tendons become severely inflamed or damaged, the dog may experience periods of lameness. This inflammation is often caused by overuse of the tendons during exercise. Issues involving the tendons can often be diagnosed using radiographs or ultrasound imaging. 

One way to treat this problem is through a surgical procedure called a tenotomy. During this surgery, the long head of the tendon is released from the shoulder joint. This relieves the pain caused by the tendon, but results in some decrease in limb movement. Tenotomies are often done arthroscopically, using small incisions portals and fibre optic imaging. An ACVS board-certified veterinary surgeon should perform this operation. It is widely used in dogs after therapeutic treatment has failed. 

Before surgery can be attempted, full blood work will need to be run to determine whether the dog will be able to survive the use of general anesthesia. If the dog is deemed healthy, ultrasounds may be taken to help plan the surgery details. You will be advised to make your dog fast 6-12 hours before the surgery. To prep the animal for the operation, the joint area will need to be shaved and cleaned. 

Depending whether the tenotomy is done arthroscopically or not, either one large incision will be made or multiple small incisions will be used. The long head of the bicep tendon is then cut. This causes the tendon to be released from the shoulder joint. The tendon is then shortened and remains contracted in the leg. The incision or incisions can then be closed using sutures or staples.

The use of a tenotomy in treating dogs with tendon damage is linked with good outcomes. At two years post-surgery, the majority of dogs experience no adverse symptoms and are able to walk normally. In general, dogs are able to recover quite quickly from a tenotomy procedure. If the operation is done arthroscopically, the recovery may be even faster. 

Compared with a tenodesis operation, tenotomies are associated with less complications but result in a smaller range of motion in the affected limb. If the tendon has deteriorated to the point where surgery is needed, it is unlikely that the dog will respond to therapies alone. 

The dog should be monitored as the anesthetic wears off to ensure vital functions return normally. Pain management should be given to the dog as it gains consciousness. The incision site will need to be kept clean. Report any signs of infection to your veterinarian. An Elizabethan collar can be used to prevent the dog from licking or biting at its incision.

The dog's activity should be limited in the first few weeks after the operation. A follow-up appointment will be needed two weeks post-surgery to assess the healing of the joint and to remove sutures. Exercise can be slowly increased from this point onward. Physiotherapy and hydrotherapy can be used to increase the dog's range of motion. A full recovery can be expected within three months.

A tenotomy can cost anywhere from $1,500 up to $5,000. This procedure is often performed using an arthroscopic camera. This equipment is expensive and requires extra training, which makes the surgery cost more than open surgery. Tenodesis may be chosen as an alternate surgery, although costs may be higher for this procedure. Medical therapy can cost less, but needs to be ongoing and can prove ineffective in some cases.

As with all operations, the use of general anesthesia comes with rare but serious risks to the animal. Upon recovery, some dogs experience lasting leg discomfort and muscle weakness. The leg may look mildly deformed due to the shortened tendon. Infection of the incision can happen but is uncommon. The majority of dogs have no complications from this surgery. While the procedure can be more complicated, tenodesis may result in greater limb mobility than tenotomy.

To prevent the need for a tenotomy, there are steps you can take to lower the risk of injury to your dog. Older dogs of larger breeds experience tendon issues more than younger and smaller dogs. Keep your dog on leash when on walks to prevent blunt force trauma from moving vehicles. Be aware of any repetitive injuries that are sustained by the dog. Do not allow your dog to jump up on high objects.