Discussion related to the musculoskeletal system - injuries, post-op, lameness, extremity issues (joint, muscle, tenon, fascia...), axial skeleton issues, etc., as it relates to canine rehabilitation.
Bentleigh is a 7 year 7 month old FS Beagle mix. She was diagnosed with Immune mediated Polyarthritis in March 2017. She initially responded well to immunosuppressive doses of Prednisone but within the past month, Bentleigh's symptoms have worsened.
She has severe carpal hyperextension and valgus in both the right and left carpus as well as crepitace and joint effusion. AND, Bentleigh has crepitace and joint effusion in both stifles. The surgeon feels that she may have bilateral cruciate tears (at least partial). There is generalized muscle atrophy present.
It is becoming more and more difficult for Bentleigh to walk.
I have contacted Hero Brace to discuss the possibility of using a non-jointed carpal brace for Bentleigh.
Any suggestions on how else I might be able to help this sweet girl?
So, firstly, I'd not contemplate surgery. It would likely be a disaster.
Secondly, I'd think about getting a quad cart so that she could go for longer walks and not trash the joints.
Thirdly, in cases where a dog is non-responsive to traditional therapies, I provide names of holistic / homeopathic / Chinese-medicine vets who could maybe offer a different approach. (Several of my clients have been hugely grateful for directing them to someone who can offer a different way of thinking and treating. And they continue to see me for their rehab/physio needs.)
Fourthly, you could brace those carpal joints... but do a trial first - using vet wrap, and maybe some padding for support. If better, then order a brace, if not, then stick with a cart.
Thank you, Laurie!
Yes, an alternative approach would be a great idea!! I will look to see who I can find in the area!
What is a quad cart? I will do an internet search to see what I can find!
I have considered using vet wrap for light support; I just didn't think it would be enough ....the owner is currently using a generic carpal brace but it does not appear to have much carpal support and it looks uncomfortable to me! When you say "padding for support" what kind of padding would you use? Something like cast padding?
PS - the internist Bentleigh saw asked for a consult with the surgeon! I don't know how you could really evaluate her stifles for CCL tear with all of the effusion and crepitace! Everything just feels "mushy" I feel so bad for this little girl!
All my best to you,
Juli
So a quad cart is a 4 wheeled cart. It can help to support both the front and back end. Alternately, if you think the fronts are far worse, then look for a front wheeled cart. I just had one of my patients get a custom one from Eddie's Wheels (unfortunately, I didn't get to see it yet because I was out due to the gut pain which was then to be realized to be appendicitis). The people at Eddie's Wheels are great... but I don't like their rigid rear leg saddle/seat for dogs that have rear leg movement - their hip movement is restricted. You could also look at Doggon Wheels. And I don't know if Walkin' Wheels has come up with a Quad Cart version yet or not... We stopped using them a while back (nice and adjustable, which also means that they have more shimmy and can break apart more easily as well.)
For the carpal wrap, my thought is just something to test increased rigidity in the carpus. So, yes, something like casting padding wrapped in vet wrap, as a test. You just want to see if there's a point to purchasing something more custom. I LOVE the Therapaw line of products and how versatile they are with being able to increase or decrease rigidity. If you test worked out. Then go with a Carpo-Flex. If you find the CarpoFlex to not be enough or to be causing too much rub, then next go with Hero Orthotics. But with this dog, I would stage it. Have the owners be aware that since you don't know how the rest of her joints will hold up if you try to stabilize just the carpi, you want to 'stage' your strategies.
And hopefully (if she does go to an orthopedic surgeon, they'd not touch her with a ten foot pole b/c of the IMPA!