Evaluating forelimb lameness in 5 steps

Earlier this year, Leilani Alvarez, DVM, DACVSMR, CVA, CCRT, head of the Integrative and Rehabilitative Medicine Department at the Schwarzman Animal Medical Center in New York, New York, led a session on practical tips and clinical pearls for evaluating and treating forelimb lameness at the 2026 Veterinary Meeting and Expo in Orlando, Florida. In this follow-up interview, Alvarez shares the key takeaway from that session, highlighting a 5-step framework she encourages veterinarians to use when working up forelimb lameness cases. According to Alvarez, that systematic approach helps guide the development of an effective treatment plan.

To learn more about forelimb lameness from Alvarez, check out:

• Two modalities advancing shoulder tendinopathy treatment
• Why the diagnosis changes treatment for forelimb lameness
• Simple visual clues to differentiate forelimb lameness issues in dogs
• The diagnostic puzzle of canine forelimb lameness
• Nutraceutical considerations for soft tissue injuries and osteoarthritis
• Forelimb lameness: The key to recovery is owner education

Below is the video transcript, lightly edited for clarity.

Alvarez: Hi, I'm Dr Leilani Alvarez. I'm the head of integrative and rehabilitative medicine at the Schwarzman Animal Medical Center in New York City.

The key points that I hope attendees remember from my session is to have a systematic approach to working up the forelimb lameness. And I talked about 5 steps.

[Those steps are]:

1. History.
2. Gait and posture evaluation—using your eyes to localize where the problem is so that then your orthopedic and soft tissue exam is focused on that location ([which is] step number 3)
3. Orthopedic and soft tissue exam.
4. Step number 4 is a neurologic evaluation.
5. And step number 5, which is really important, is diagnostic imaging that's going to give you your definitive diagnosis.

Once you have that systematic approach, then you can come up with a treatment plan that is going to be effective.