Toes

[Kriszty]

Hi again Laurie and David,
I have another question about my dogs.. different one though this time! 10m old Border collie X . Pulled up very lame after swimming /running around dam 2w ago. Pain on toe 5 RF P1, esp flexion. Tried to rest her, lameness has improved but she will still hold that paw up intermittently and still has pain on flexion. No obvious swelling or crepitus. Very keen to run and play. I know toes take awhile to heal but is there anything I can do to speed up.. was thinking PEMF mat, traction of toe, maybe ESWT (If so would you comment on settings?)
She is little, 7kg. And of course an agility dog.
Thanks!!
Kriszty

[David Lane]

PEMF and laser would be my choices to accelerate healing. ESWT skin over a bone without soft tissue interposed doesn't always go over well, so any foot ESWT I do is through the pad. Preventing re-injury is the other concern, so I would have a soft bandage on it while outside to avoid additional insults. That should be enough for a minor sprain.

[lehughes]

I suppose it could be a wee non-displaced fracture (prox phalanx or sesamoid), or ligament sprain, or strain of SDFT or DDFT.

I'd agree with David in regards to suggested therapies.

Additionally, if you think there is the potential for a hairline fracture or something of the like, I've found that adding padding into a sock (i.e. baby sock) or a bootie, helps to cushion the paw to allow painfree walking. But if that's the case, then you have to allow for 6 - 8 weeks to heal. So keep testing for pain along the way. Know exactly where it is, so you can see if/when it dissipates and resolves. Thus your decisions about returning to practice are a bit more objective than just watching how the dog moves.

Best of luck!

Laurie

[Kriszty]

Thanks guys.
I xrayed it last week and yes, it is fractured. Chip fracture of the distal aspect of P1. She is not lame walking and I am trying to keep it at that..will hold it up if she gets faster. I am hoping 6w will do it, but will give her longer if needed.
What is the likelihood of this causing issues in the future, do you think? One of my others has a small minimally displaced F# in her hock and will off weight that leg at times. Nothing else found on CT. The ortho vet said it wasn't causing any pain, but I have to wonder.. ?

Harli toe.jpg (238.05 KiB) Viewed 736 times

[Kriszty]

Can you please let me know what settings you are using on your PEMF mat- I looked up the modalities article but couldn't make sense of it.
Also, are you still recommending E-stim for F#?
Thanks!

[lehughes]

Well, at least you know what you're dealing with now.

I'd use 5Hz for the PEMF. Essentially, with PEMF you don't get much choices. The lower Hz are better for acute injuries and the mid to higher are better for OA & Chronic things.

You could shockwave... but I'd hold off on that one. I don't think I'd put it in my arsenal of 'necessary' for a fracture. I think it made sense when the thought was soft tissue.

You mention e-stim here, but that's a new addition to this conversation. I'd not find that to be necessary either.

Fractures are sort of boring waiting games. PEMF & Laser, and modifications as needed.

Sorry!!

Laurie

[David Lane]

To me, that looks more like a soft tissue mineralization than it does a fracture (with all the disclaimer of jpeg resolution, no orthogonal view etc.).

[Kriszty]

Thanks. The ortho specialist thinks it is a sesamoid F#.
She seems to be getting better slowly. No longer has pain on direct palpation, but still pain on flexion. Its been nearly 6w, so hoping I can start running her again soon.
Would be nice to have a laser, but my work is not interested and its lot of $$$ for my animals. I know you can get cheap ones, but I am assuming they are not worth it.

[David Lane]

For clients buying a personal laser (where they don't care how long it takes to administer the therapy), you can get a decent unit for $3000 CDN. A unit like that would not function well in practice as therapy would be too time consuming.