SDF Luxation

[Tgriffin]

Has anyone dealt with an SDF luxation conservatively? I have a 9 month old Bearded collie that was diagnosed in January and at that time the tendon was swollen but in place. We have been doing laser and gradual increase in exercise and things have gone well. On the weekend the owner was leash walking the dog on some uneven ground (hay field) and the pup was bouncing a bit and had a 10-15 second episode where she held the foot up with digits flexed and after some gentle massage by the owner she put it back down and has been fine ever since. This is the first such episode in 2 months and the owner is freaking this is a huge setback. It is a show and agility dog (hopefully). So do we think this is just a blip indicating things aren't totally healed? or an indication that it is not going to heal conservatively?

Tracey

[lehughes]

Hey Tracey,

Just some questions for clarification...
Rear leg I assume?
Where about are you feeling the swelling?
Main tendon or or any involvement lower down?
Are you able to isolate pain to one component with individual digit extension?
what have you been doing / the owner been doing / what's been prescribed as an exercise program?
Other therapies?

Sorry... more questions!

Laurie

[Tgriffin]

I can tell you more now as I saw it today. LRL and was diagnosed by David Lane Mid Feb but dog came up acutely lame in mid January. Would hold up Rear leg for a few seconds then put it down as if there was no problem. According to owner a golf ball size fluid swelling at that time. I have been seeing it for 8 weeks, gradually increasing the straight line strengthening exercises and lasering. I have not felt there was any pain ever. The soft fluid swelling disappeared about 3 weeks into the treatment, but there was still thickening of the tendon as it passed over the calcaneous and a bit cranial and caudal. Don't feel that there was any other structures involved. 4 days ago there was another episode of 10-20 second NWB lameness that disappeared with gentle massage and then the dog was 100% sound (this owner would notice even the slightest lameness) She thinks maybe the dog twisted the leg in a rut in the field but she is just guessing as she didn't see anything (it was on leash). Today all of the thickening was gone and I can say that for the first time I could palpate both edges of the tendon and it seems to be siting a bit medially as it goes over the calcareous and is a bit sloppy, but I wasn't about to force a lunation with a freaked out owner in front of me. Dog is still not painful or lame.
Enough info? A setback? or indication surgery will be required?

[lehughes]

Hmmm...

Well, I'm not a surgeon, and unfortunately, I've never had one of these cases before.
I'd do a round of eccentric exercising (sit to stands facing up hill, backing up, backing up going downhill, trotting on an even surface, tug of war), and then see what you get. Gradually adding jumping up onto something (i.e. back of vehicle, bed, picnic table) as a progression if all went well.

In my head surgery will still be available. if the advanced strengthening doesn't help, or has already been done, then no harm in getting a surgical consult (of course advising wisely as to where to go for an unbiased consult).

I'd love to hear some other thoughts on this as well!

Cheers,

Laurie

[vetsurgsj]

From the surgical perspective, I recommend surgery. I do not believe this is a case for conservative management. Surgery has a good to excellent prognosis for this. Sometimes it is the conformation of the calcaneus that is making it slip.
I would at least advise referral to a local surgeon to evaluate, perform radiographs and discuss surgical treatment with the owner, especially since it keeps recurring.
Caroline Garzotto

[lehughes]

Thanks for piping up Caroline!
That's really useful to know!
Laurie