Hello
Would love some thoughts on this little nugget please.
Luke is 12mth old WHWT. He had a RIGHT FHO due to legg calve perthes at 8mths.
His FHO leg is now doing well, we had some immune-mediated issues needing steroid post op. Anyway, we are working on getting the RHL muscle mass improving, now that he is using it well. However a new (not so new) issue is that his digits are hyper extending (they do on both HLS but now becomeing an issue on the R) and he has now walking on the non-fleshy part between the main foot pad and the digit pads on both HLs. The R FHO limb is now more affected as it's really reaching to the ground), so much so that the skin is irritated.
Videos for your viewing pleasure in slow mo.
https://www.youtube.com/watch?v=jwGjPCa ... load_owner
https://www.youtube.com/watch?v=FDOyRZx ... load_owner
Ickle boots to protect? Any other ideas?
Please feel free to comment on the FHO rehab side also- we have good flexion with sits and commando crawls. No pain, clear on Xray. We use a leg weight, inclines. UWTM not available.
thank you
Jane
Hyperextended digits bilat HLs (and post FHO)
Re: Hyperextended digits bilat HLs (and post FHO)
Hey Jane,
Okay, so I am trying to understand your description of the foot. Do you mean that the foot is flattened out (sort of like multiple SDFT avulsions)? I can't see the foot well enough in the videos. Could it be that the steroids weakened the tendons, allowing them to become damaged or stretched? If so then, yes, some sort of booties might work.
Oh, have you tested extensibility of each of the DDFT & SDFTs? And compared front to back. The foot thing is weird.
What is odd is that his RH leg extension looks pretty good... odd only because that's where you expect to see the issue. However, his LH is lacking extension and/or his RH is not reaching as far forward. I'd say to check extensibility of the hamstrings and possibly the sciatic nerve as well. Is the L hip clear?
YOu get the craziest cases Jane!!
Laurie
Okay, so I am trying to understand your description of the foot. Do you mean that the foot is flattened out (sort of like multiple SDFT avulsions)? I can't see the foot well enough in the videos. Could it be that the steroids weakened the tendons, allowing them to become damaged or stretched? If so then, yes, some sort of booties might work.
Oh, have you tested extensibility of each of the DDFT & SDFTs? And compared front to back. The foot thing is weird.
What is odd is that his RH leg extension looks pretty good... odd only because that's where you expect to see the issue. However, his LH is lacking extension and/or his RH is not reaching as far forward. I'd say to check extensibility of the hamstrings and possibly the sciatic nerve as well. Is the L hip clear?
YOu get the craziest cases Jane!!
Laurie
LAURIE EDGE-HUGHES
Re: Hyperextended digits bilat HLs (and post FHO)
Jane,
I see very little protraction in the right pelvic limb during the swing phase and on the first video suggestion of proprioceptive deficit in the lower limb. I am of the opinion your patient is compensating for this impairment by pushing off much harder in the left pelvic limb to allow the right pelvic to clear the ground with limited protraction. I suspect injury to the right sciatic, perhaps more to the peroneal portion but cannot tell for sure.
Rick
I see very little protraction in the right pelvic limb during the swing phase and on the first video suggestion of proprioceptive deficit in the lower limb. I am of the opinion your patient is compensating for this impairment by pushing off much harder in the left pelvic limb to allow the right pelvic to clear the ground with limited protraction. I suspect injury to the right sciatic, perhaps more to the peroneal portion but cannot tell for sure.
Rick
Re: Hyperextended digits bilat HLs (and post FHO)
Thanks a bunch Rick and Laurie. Great ideas..... I will investigate nerves further.
Yes weird cases because we have the most excellent inbreeding programmes and no kennel club to register your anything. I remember seeing a Westie dyed purple and clipped like a Schnauzer. New owner devastated when I pointed out the regrowth. But then not as bad in Japan where some innovative Aussies sold baby lambs as puppies.....baaahhh
Yes weird cases because we have the most excellent inbreeding programmes and no kennel club to register your anything. I remember seeing a Westie dyed purple and clipped like a Schnauzer. New owner devastated when I pointed out the regrowth. But then not as bad in Japan where some innovative Aussies sold baby lambs as puppies.....baaahhh
