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fracture toe, amputation or not


lecar
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i need some suggestions of what you know people/vet do in this kind of cases.
We have a 6 year old BC; he was licking his paw/leg in the middle of it. after lots of research, we found out he has a broken toe (the second of the 5 toes) with a callus. As he never complained nor limped, and he never showed pain (it doesn't mean he has or not, because he always keeps everything for his inside), we don't know when he fractured his toe, it may be years or not. The vet told us that the fracture weld only in one side, and, as there is a line on the x- ray, that part isn't weld. If the fracture is new (he think it is not probable), it can be weld convert all in one bone and all be ok. If it is old, he doesn't expect it will weld and, when that line with cartilague, support some efforts and on that efforts/movements, the dog may suffer. Also he think what he licked in the middle of the same leg is because of a nerve connected to his toe. If that is the case he want to amputate his toe. We live in southamerica and they are not used to treat working dogs, but the dog that sits by the armchair to see TV. I don't have problem to amputate his toe if it is the best for him, but i am not sure what it is done in first world (I put links of what I found on internet). If I accept and make a mistake i can't return his toe later, there won't be a return path to old situation. I need to know what people knows/experience


many thanks

 

 

post-15315-0-64480600-1374973591_thumb.jpg

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Did they put a splint or cast on his foot? I would keep it supported and protected for a few weeks and then re xray it to see if it is still healing. That will give it a chance to get better.

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Id give him 4-6 weeks more time, re-xray to see if there are changes. My young pup broke her radius and ulna. Even with her being so young if took about 10 weeks before the vet removed the stabilizer. The X-ray showed something similar to what your dogs toe looked like at that time. It was sorta stair stepped in the union. But totally remodeled so vet said it didn't matter. She has no visible limp 6 months later.

That being said, a friends dog tore a muscle in her toe and the doc really pushed for amputation. She didn't do it and 12 weeks +/-later, dog was fine.

time will help with your decision.

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many thanks for your quick answers :) .
they didn't put nothing on his toe and they say he can run (for them the matter is if there is pain for amputate, if there is no pain, they suggest goiing on with normal life) but i am trying to let him with the less exercise I can.
I took the x rays with a vet that doesn't ask for an order from a vet, so I can do it again with him in some weeks :)
thank you very much again

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Welcome!

 

I agree with both replies - give him some more time to see if there is continued healing, and splinting or casting might be an option if there is still any instability or movement between the two pieces of bone.

 

Exercise that is less vigorous is a good idea to lessen impact on the foot.

 

Very best wishes!

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I think I'd put him on complete rest for a few weeks and reevaluate. Because it's a toe, if he's running around, he's going to put pressure on that spot, which could slow or prevent healing. The fact that he's licking at it says to me that it is bothering him.

 

I would ask the vet about a splint or wrap to stabilize his toe for the rest period and then as others have said, re-X-ray and see if there's been any additional healing. If not, at that time, you can make a decision to amputate, but you will be doing so with the knowledge that you gave it plenty of time to heal before the last resort of amputation.

 

FWIW, I have a friend who had to amputate one of her dog's toes (can't think of the reason now, but either injury or infection, and the dog does just fine without the toe.

 

In a sort of related thing, I used to run. I made the mistake of running in old shoes. This was years ago--the 1990s. I developed a stress fracture in one of the tarsal bones in the ball of my foot. The orthopedic foot doctor at the time told me that a sort of flexible callus would form there but that the bone would never heal completely (which is what it sounds like your vet is saying). I can say that I still have pain in that spot. Not all the time, but especially when I'm active, and if I jog/run, I have to use special support in my shoe to keep pressure off that area of my foot (but even when I do that, I still have pain--not unbearable pain. but pain all the same). So I do find it believable if the vet feels that the break may never knit entirely, and I think the reasons are similar--it's a high impact area that you can't easily keep completely stabilized, and if the recalicified area is at all weaker than the surrounding bone, then it's always going to be a potential point of reinjury,

 

J.

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many thanks for all your answers, all seem to go in the same direction, but each one added important things.

since today i started with my dog in full rest, only walking on a leash, trying not to go running nor jumping, instead trying to do mental excercises It doesn't seem that any vet in this side would split, wrap or cast the toe, but i will try to talk with them about doing it..

thanks again

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I took my dog to an orthopedic surgeon for a toe problem (her toe kept dislocating at that same joint). He suggested immobilizing it for 4-6 weeks and then no running or quick turning on it for 6 months to allow time for it to heal. He also recommended cartrophen injections to help the joint (once a week for 4 weeks then once a month for 6 months). He said if it continued to cause issues, they could do surgery to fuse that joint together so it wouldn't be painful to her. The rest worked in her case to stop it dislocating however she did have arthritis in both front feet the outer and inner toes of each foot from all the abuse and quick turning she did when younger.

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thanks.i have already asked one of the vets about cartrophen injections after reading this post.
there are some things that i can not have in the third world like the orthopedic surgeon (and other things) but i will try to do the best i can and the more i can to see how it goes on.
thanks again really :)

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  • 1 month later...

We X rayed again the paw to re evaluate. He was with the less impact effort i could for nearly 7 weeks. I couldn't find cartophen injections but tried to find similar products. the only similar products in my country are for horses :( .

 

 

We still have to go to the vet again. We think the left part of the fracture is welding. Not too much but at least something. As the 2 Xrays have very different quality. I used paint/software to try to compare both of them.

 

Someone told us that the callus may cause him pain. Others that the callus will remodelate with time. For the moment we think we'll wait till march and reevaluate his toe, but we must see what the vet says. Vets (that are not his official vet) told me that the fracture should be very old, and that he can jump, run, etc with no side effects, that the pain should come from the callus. Perhaps they are right, but with no activity it looks he is not licking anymore in the middle of the leg (where it is the nerve that goes to his toe)


As I cannot upload the images i will put them in a blog and share the images links.

 

this is the new x ray with all his paw

 

 

DSC_0019.JPG

 

 

 

left new x ray, right old one (then a closer image old x ray (on the left) vs new x ray (on the right))

 

dedo3.jpgdedo2.jpg

 

 

 

or in the blog where the image can be clicked

 

http://uno-alifeinsouthamerica.blogspot.com/2013/09/xr-toe-september-2013.html

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Did they suggest you get the Cartrophen injections in the toe joint or IM or sub cue?

 

Just wondering? And if you did it, did it help?

 

Bonnie

 

I took my dog to an orthopedic surgeon for a toe problem (her toe kept dislocating at that same joint). He suggested immobilizing it for 4-6 weeks and then no running or quick turning on it for 6 months to allow time for it to heal. He also recommended cartrophen injections to help the joint (once a week for 4 weeks then once a month for 6 months). He said if it continued to cause issues, they could do surgery to fuse that joint together so it wouldn't be painful to her. The rest worked in her case to stop it dislocating however she did have arthritis in both front feet the outer and inner toes of each foot from all the abuse and quick turning she did when younger.

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a surgeon orthopedic suggested the Cartrophen injections (once a week for 4 weeks then once a month for 6 months) to Bcjetta and he/she shared it in the forum (in this thread).

i don't live in the first world :( and couldn't find the injections here. i don't know if they would work in his case.

 

BCjetta: do you know if the injections are in the toe joint, IM, sub cue?

 

 

Did they suggest you get the Cartrophen injections in the toe joint or IM or sub cue?

 

Just wondering? And if you did it, did it help?

 

Bonnie

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BCjetta: that's very interesting.

I was told that the right part of the joint isn't broken, but the left part (where the callus is) is broken.
which could then be the reason of the callus?

thank you very much for the observation :)

 

Looking at the x-rays again, I'm not sure that toe was broken...it looks like the callus is at the joint between 2 of the bones in the toe.

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  • 2 weeks later...

I did the cartrophen injections subQ. It seemed to help a bit. I also had her on glucosamine and green lipped mussel powder.

 

There is another drug called adequan that you can use. It comes in a canine and an equine form (same drug but equine is a lot higher concentration per ml)

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