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An elderly Lab with a 2 year history of 'hock' injury leading to capped hock and a recent injury that looks like gastroc tear. Curled toes indicating SDFT still intact and hock NOT dropped. He is weightbearing about a third on the limb (so not much). No xrays or further investigations have been done at this stage.

Is conservative treatment likely to resolve the curled toe issue and improve weight bearing to give him quality of life? Or would surgery be the only way to investigate full damage and do a decent repair in order to improve his weight bearing status?

If conservative I am going to support the hock with a neoprene support - do I want to have allow NO flexion movement during gait in the hock while it heals? Do I support it in a more extended position than functional stance? or in functional stance length? - 6 weeks for healing then start to allow movement ?

Do I ignore SDFT for now i.e no stretching - and no attempt to get foot into correct position?

I have only ever worked on a post op repair of cal tendon issues so not sure if conservative treatment stands a chance.

Thanks
Nycky

Hey Nycky!

So my 2 cents! (1 pence)...

If the toes are curled, the achilles has likely already retracted, meaning that surgery is not even an option at this point. Should they still want to do surgery, they could end up with a very short gastrocs tendon and a potential for surgical failure.

I'd go with conservative - because of age and because of the status of the foot and tendons now. Those curled toes are staying.

I'm not sure I'd stretch the SDFT... but I don't think you would actually change what was going on anyways. Likely the best way to put a wee stretch on the SDFT to get better function (i.e. foot position) would be sitting practice - ensuring the hock is flexed and the foot is on the ground, while the dog is rewards for staying in this position for an extended period of time (i.e. 30 seconds to 2 minutes if able).
There isn't anything left to heal - Gastroc tendon is gone. SDF is doing all of the work.
You're new goal becomes function, support, and preventing compensatory issues of maintaining function elsewhere (i.e. spine, hip, SIJ, thoracic spine...).

I'd likely allow some movement in a neoprene support - so no thermoplastic, but yes to some additional straps & velcro. Honestly, it's easy to add or remove a thermoplastic... so you could have it as something to try. That being said, many dogs offload limbs that are 'rigidly' supported, so it might not improve function anyways. Oh, and brace in a functional stance position I think... or rather whatever is the 'new' functional stance.

From a therapeutic exercise standpoint. Work on weight bearing on that limb. Simple 3-leg stands, progressing to diagonal leg stands.

Great questions Nycky! Best of luck with this senior!

Laurie

thank you Laurie