OA Carpus & Hyperextension

[lehughes]

Aloha Laurie!

Mila is a 13 yr old FS Pit mix who I evaluated about 6-8 weeks ago
for reluctance to walk. Among other ailments, she has severely
thickened carpal joints, with reduced flexion and an initial empty end
feel. I have gotten her joint pain under control with a multimodal
analgesic plan, including pharmaceuticals (NSAID, gabapentin, a course
of amantadine), nutraceuticals (fish oils, chondroitin/glucosamine),
curcumin), electroacupuncture/laser therapy, cryotherapy, etc. The
empty end feel has now turned to boney; upon watching her stand/walk,
she demonstrates moderate carpal hyperextension. In addition to
therapeutic exercise to improve digit strength (potential SDFT
injuries too?), the owner and I discussed potential bracing to improve
comfort levels, mobility, and limit acute inflammation. Specifically,
do you have recommendations for brands of carpal braces (normally, I
use GoHeroGo, but want to see if there was anything less cumbersome).

J.

[lehughes]

Aloha J.

So, my thoughts regarding the first dog. Sounds like you have a wonderfully comprehensive plan. I would add joint mobilizations for pain management, and show the owner how to do carpal traction as an addition to any home program.

In regards to bracing, I love HERO, but for this case, I’d not start there either. I’d go with a Therapaw Carpoflex wrap, which can have padding, straps, and thermoplastics added to it for additional support as needed. However, one of the key things I learned from the Bracing Course I took from Ilaria Borghese (owner of Therapaw) was the value of doing a “mock-up” before jumping into a purchase. So, to that end, why not try wrapping the carpus… maybe some padding and vet wrap, and you could add something with some support up the back… or just double the padding along the back side. See how the dog walks with these. If immobilizing the joint in this way making walking more difficult and therefore reduces mobility, then it’s not worth it.

Sometimes you need to weight out the options with the Geri-dogs. I’ve had some where the owner and I have chosen to do nothing… because the bracing, splinting, wrapping, bandaging caused other issues and impeded mobility, which really defeated the point overall.

So, Dog 1: Test first, if okay, then Therapaw would be my first choice.
Ohhh, and shorter toe nails would also contribute to a better foot placement too! Owners & toe nails… oh my!

Now onto Dog 2…
Laurie