Carpal Hyperextension in Dogs
Dr. Nicholas Trout
The toes can be seen at the bottom of the bandage and they may be somewhat swollen, but your veterinarian will guide you as to how much swelling is normal, and when to be concerned. Although swollen, the toes are not normally painful. However, they may sweat and become moist, necessitating cleaning with a moist cotton ball.
The swelling subsides dramatically within the first week, so your dog may require a cast change to enable a better fit and support. Your dog should not place any weight on the limb initially, but he can begin to do so gradually over the next few weeks.
Strict rest is essential, which means no going up or down stairs and no jumping on or off furniture. Avoid slippery surfaces such as tile, linoleum or hardwood floors. Leash walk only to go to the bathroom and eliminate regular walks. When outside, place a plastic bag or trash can liner over the foot to keep it clean and dry.
The incision over the front of the wrist and down the paw cannot be seen under the splint or cast. For this reason, look for any discharge seeping through the bandages, any foul smell, or your dog pulling or biting at the bandages. If you have concerns, have the cast checked by your veterinarian. Stitches or staples can be removed 10 to 14 days after surgery.
X-rays of the carpus will be redone around six weeks after the procedure to assess healing. Depending on how things look, the cast may be reduced to a splint, or even a soft padded support bandage for a few more weeks; in this way, slowly downgrading the amount of external support so that the healing fusing bones have to work a little harder. The carpus may be X-rayed again in four to six weeks.
All external support may be removed from eight to 12 weeks depending on the damage, the type of fixation, the age of the dog, and so forth. If the plate or pins are not causing any problems, they can stay where they are. In some cases, pins may back out and need to be removed, or plates, particularly in partial fusion, may impinge on the large radio-carpal joint, and are better off being removed.
In order to create a hyperextension injury to the carpus, a significant downward force must be applied against the ligaments holding up the back of the wrist. Depending on the size of the dog, certain household falls may create the kind of conditions necessary for just this sort of injury to occur. A small dog should not be allowed near an open upstairs window. These simple limitations on activity can help reduce the likelihood of this type of injury occurring to your dog.