Vet Comp Orthop Traumatol 6/2010
406 © Schattauer 2010 Original Research
Comparison of four
commercial devices to measure
limb circumference in dogs
S. G. Baker; J. K. Roush; M. D. Unis; T. Wodiske
Department of Clinical Sciences, Kansas State University, Veterinary Medical Teaching Hospital, College of Veterinary
Medicine, Manhattan, Kansas, USA
Keywords
Muscle mass, limb circumference, physical
therapy
Summary
We evaluated four measurement devices for
obtaining circumferential measurements at
four locations on the canine hindlimb and
forelimb. We hypothesised that these devices
would be consistent and precise in the hands
of veterinary professionals with varying ex-
perience levels. Circumferential measure-
ments were made in five dogs with no history
or clinical evidence of orthopaedic disease.
Measurements were obtained in triplicate by
three observers at mid-thigh, tibial tuberosity,
hock and carpus bilaterally. Results indicated
a significantly larger measurement at the left
Vet Comp Orthop Traumatol 2010; 23: 406–410
doi:10.3415/VCOT-10-03-0032
Received: March 8, 2010
Accepted: June 24, 2010
Pre-published online: September 9, 2010
Correspondence to:
Steven G. Baker, DVM
Kansas State University
Department of Clinical Sciences
Veterinary Medical Teaching Hospital
College of Veterinary Medicine
1800 Denison Ave
Manhattan, KS 66506 , USA
Phone: +1 785 532 5690
Fax: +1 785 532 4309
E-mail: sbaker@vet.ksu.edu
mid-thigh region than the right, with no sig-
nificant differences between limbs noted at
other sites. Measurements with a tape
measure and a retractable tape measure re-
sulted in significantly smaller values at each
site than an ergonomic measuring tape and a
circumference measuring tape. Interobserver
variation was 3.6 times higher than intraob-
server variation. These results illustrate the
importance of consistency when obtaining
these measurements. Sequential circumfer-
ence measurements should be made by the
same individual using the same device to de-
crease measurement variability. Devices were
equally precise for repeat measurements al-
though the absolute measurement varied by
device.
Introduction
Accurate measurement of limb circumfer-
ence is important for assessment of the effi-
cacy of physical therapy with veterinary pa-
tients. Thigh circumference has been used
to objectively monitor muscle mass (1, 2).
These measurements have been reported as
methods for detecting muscle atrophy
from disuse following orthopaedic injuries,
and subsequent return to normal circum-
ference after surgical correction (3, 4).
Simple tape measurement has been shown
to be comparable to more sophisticated
methods of assessing muscle mass in dogs,
such as B-mode ultrasonography (5). Vet-
erinary orthopaedic surgeons and physical
therapists frequently use thigh circumfer-
ence both pre- and postoperatively when
evaluating limb use and function following
surgical techniques such as coxofemoral
and femorotibial arthroplasty, fracture re-
pair, surgical stabilisation of ligament in-
juries, arthrotomy, and arthroscopy (3, 4,
6–14). Circumferential measurements
were also used in two recent studies assess-
ing the effect of various therapies on post-
operative swelling after surgery to stabilise
cranial cruciate ligament-deficient stifles
(15, 16). Several different measuring devices
have been used in previous studies measur-
ing limb circumference in dogs. These in-
clude the spring-tensioned tape measure,
circumferential tape measure, and standard
tape measure, most of which are non-stret-
chable nylon fabric or fiberglass.
In human medicine, circumferential
measurements of various structures are
used in many applications, including as-
sessment of chronic venous insufficiency
and the associated peripheral oedema,
measuring children’s occipitofrontal cir-
cumference to indirectly monitor brain
growth, and gauging muscle atrophy fol-
lowing orthopaedic surgery (17–21).
Studies have demonstrated that thigh cir-
cumference is strongly correlated with
quadriceps muscle mass, and reliability of
these measurements appears to be high
(22–25). Precise and accurate measure-
ments are also paramount in the field of
prosthetics, as one study evaluating the
consistency of measurements of several an-
thropometric devices found overall mini-
mal variability (26). Furthermore, the de-
gree of muscle atrophy as measured by
thigh circumference following anterior
cruciate ligament reconstruction directly
correlated with deficits in isokinetic quad-
riceps muscle strength (20). In order to
consistently measure calf circumference, a
device (Leg-O-Meter) with a tape measure
affixed at a certain vertical height was de-
veloped, which has been shown to be re-
liable and accurate (19, 27, 28). To the au-
thors’ knowledge, such a device has not
been evaluated on canine patients.
The purpose of this study was to compare
interobserver and intraobserver variability
when measuring the circumference of canine

Observer one (MU) was a first-year surgery
resident familiar with these measurements
from a previous study, observer two was a
veterinary technician with similar experi-
ence from the same study, and observer three
(TW) was a veterinary intern with no clini-
cal measuring experience. Each observer
performed his or her measurements inde-
pendent of the other, although all measure-
ments were taken within a three hour
window during which the dogs were con-
fined to their kennels and no treatments or
medications were administered.
Measuring devices
Four commercially available, medical grade
tape measuring devices were used for this
study (Fig. 1). Each device was used as rec-
ommended in the operator’s manual. The
Gulick II tape measure (GUL) devicea was de-
signed with a four ounce spring-loaded ten-
sion indicator to achieve accurate and reliable
measurements by allowing a specific amount
of tension on the measured object. According
to the manufacturer, this eliminates excessive
compression of the soft tissues of the limb and
resulting measurement inaccuracies. The re-
tractable tape measure (RTM) deviceb was a
standard linear nylon tape measure. The
SECA201 ergonomic measuring tape
(SECA)c and QM2000 circumference
measuring tape (QM)d devices were designed
specifically for circumferential measure-
ments, and were used as such, placing the pin
located on the end on the tape measure into
the tape measure body forming a loop. The
release button was then pressed to tighten the
tape measure around the limb with a uniform
amount of tension. The tape portion of every
device was constructed of non-stretchable
nylon. All measurements were recorded in
millimetres, except for SECA, which only had
one-eighth inch delineations. For this device,
measurements were recorded to the nearest
eighth of an inch, and then converted to milli-
metres using the conversion factor of one inch
equal to 25.4 millimetres.
Statistical analysis
Left versus right limb
Mean circumference was compared be-
tween left and right limbs for all observers
combined at each site, and within each ob-
server between left and right limbs at each
site by a Wilcoxin signed Rank Test.
S. G. Baker et al.: Limb circumference measurements in dogs 407
© Schattauer 2010 Vet Comp Orthop Traumatol 6/2010
limbs at four anatomic locations with four
commercially available tape measures. We hy-
pothesised that there would be no differences
between: 1) the mean circumference at each
limb location as measured by observers with
variable levels of clinical experience, 2) the
mean circumference measurement obtained
using each device, or 3) the mean circumfer-
ence between left and right limbs.
Materials and methods
Dogs
Five dogs were randomly selected from the
humane society population while hospita-
lised for elective sterilisation procedures.
All dogs were mixed breed, intact males.
Median body weight was 18.1 kg, with a
range of 8.2 to 24.6 kg. Age was not known.
No sedative or anaesthetic medications
were administered prior to measurement.
Study design
The left and right forelimbs and hindlimbs
of each dog were measured by three individ-
uals. Circumferential measurements were
performed at four different anatomic lo-
cations: mid-thigh (MT), tibial tuberosity
(TT), hock (HO), and carpus (CA). The
mid-thigh location was determined by each
observer estimating 50% of the linear dis-
tance between the greater trochanter and the
lateral femoral condyle, as previously de-
scribed (4). The tibial tuberosity location
was measured at the proximal aspect of the
tibial crest. The hock was measured around
the most plantar aspect of the calcaneus. All
measurements were taken with the limb in a
functional standing angle, as previously de-
scribed (2). The carpal measurement was
taken with the antebrachium in full exten-
sion, at the level of the radiocarpal joint. The
measurements were obtained in triplicate
with each of the four measuring devices at
different times by three separate observers
with varying levels of experience. Measure-
ments at each site were taken in nonsequen-
tial fashion so that a fresh measurement was
obtained each time. Mid-thigh, TT and CA
measurements were collected with the tape
perpendicular to the long axis of the limb.
Fig. 1
Measurement de-
vices. A) Gulick II
tape measure; B) re-
tractable tape
measure; C)
SECA201 ergonomic
measuring tape; D)
QM2000 circumfer-
ence measuring tape.
a Gulick II tape measure: Country Technology, Inc.,
Gays Mills, WI, USA
b Retractable tape measure: Prestige Medical, North-
ridge, CA, USA
c SECA201 ergonomic measuring tape: Seca North
America, Hanover, MD, USA
d QM2000 circumference measuring tape: Quick-
Medical, Issaquah, WA, USA