Re: Re:Puppy missing distal hind paw

[Guest guest]

Hello,

I an occupational therapist very interested in vet rehab. I was reading the case of the puppy missing his hind paw. I am currently fostering a pup with the same issue. He is now nearly 5 months old and has formed a good callus. He was brought into a shelter in NJ in a bloody box with two litter mates who had only one limb. He has three and he's missing three tows on his other hind paw. He had sepsis as a newborn. His tail had been docked when he was brought in to the shelter, so his foot is a mystery as to if it was at birth of an act or cruelty.

He functions well; but does hold the hind leg up on wood and concrete surfaces. He runs so fast downstairs, using 3 legs.

My concerns as he ages, developing a scoliosis? and if,when should I build him an AFO. I work with a great orthotist who can fabricate one for me. I also do some PT with him on the ball to build up his muscle bulk and balance.

I'd appreciate any guidance.

Thanks in advance,

Leilani,What a cool case. I have to say I am a great believer in the ability of animals to adapt to what they are given so my first response is to leave the pup alone and monitor. I suspect she will do fine. It doesn't surprise me that she periodically holds the leg up since it is shorter than the contralateral leg. One of the concerns is as she grows will she ulcerate the distal end hence the recommendation for the pad transfer. I would probably monitor for now and keep that as an option for later. There is a good possibility she will naturally thicken or callus the distal end of the stump to compensate for the lack of pad. If she doesn't and shows any sign of irritation/ulceration then consider the graft transfer or ‘boot’ of some sort. For now I would leave her without a boot to allow the distal aspect to ‘toughen’ as much as possible. I have a cat that as a kitten was put in a freezer and lost 3 of his 4 feet to severe frostbite. They were amputated at varying lengths. Because it was a young age his body adapted and he has great callusing of the distal stumps. Admittedly he is much smaller than a GSD but I've seen this in larger animals too. On a future note (and plug for OSU) we are gearing up to do a study involving an intraosseous transcutaneous amputation prosthesis (ITAP). Once this pup is grown if she were having difficulties she could be evaluated for an endoprosthesis. I think your idea about strengthening and conditioning is a good one. As much as I like to do surgery I would let the pup be and I bet she does just fine. Just my 2 cents, Au-- Au, DVM, DACVS, CCRTAssistant Professor – OrthopedicsDirector of the Veterinary Rehabilitation and Sports Medicine ServiceThe Ohio State UniversityDepartment of Veterinary Clinical Sciences601 Vernon Tharp St.Columbus, OH 43210

[Guest guest]

Thanks very much for this feedback.  Depending on how the dog does, the owner may be very interested in the ITAP.

Will keep you posted.

Thanks,

Leilani

 

Leilani,What a cool case. I have to say I am a great believer in the ability of animals to adapt to what they are given so my first response is to leave the pup alone and monitor. I suspect she will do fine. It doesn’t surprise me that she periodically holds the leg up since it is shorter than the contralateral leg. One of the concerns is as she grows will she ulcerate the distal end hence the recommendation for the pad transfer. I would probably monitor for now and keep that as an option for later. There is a good possibility she will naturally thicken or callus the distal end of the stump to compensate for the lack of pad. If she doesn’t and shows any sign of irritation/ulceration then consider the graft transfer or ‘boot’ of some sort. For now I would leave her without a boot to allow the distal aspect to ‘toughen’ as much as possible. I have a cat that as a kitten was put in a freezer and lost 3 of his 4 feet to severe frostbite. They were amputated at varying lengths. Because it was a young age his body adapted and he has great callusing of the distal stumps. Admittedly he is much smaller than a GSD but I’ve seen this in larger animals too.

On a future note (and plug for OSU) we are gearing up to do a study involving an intraosseous transcutaneous amputation prosthesis (ITAP). Once this pup is grown if she were having difficulties she could be evaluated for an endoprosthesis.

I think your idea about strengthening and conditioning is a good one. As much as I like to do surgery I would let the pup be and I bet she does just fine. Just my 2 cents, Au-- Au, DVM, DACVS, CCRT

Assistant Professor – OrthopedicsDirector of the Veterinary Rehabilitation and Sports Medicine ServiceThe Ohio State UniversityDepartment of Veterinary Clinical Sciences601 Vernon Tharp St.Columbus, OH 43210

-- Leilani Alvarez, DVM, CVA, CCRTCertified Veterinary AcupuncturistCertified Canine Rehabilitation Therapist

Katonah Bedford Veterinary Center546 N Bedford RdBedford Hills, NY 10507p f www.kbvetcenter.com