Kevin Broke A Toe On His Front Foot

[AEB]

Never had a broken toe, just several dislocations...personally, amputation is a last resort solution in my book. I wouldn't go hacking off my digits without trying to heal them first. If something happens to the other toes on that foot, whatcha gonna do? They only have so many. A bigger consideration the younger the dog. I also don't like wraps and splints on greyhounds unless absolutely necessary. The skin on their legs and feet is thin, has really no underlying padding and has poor circulation...it's not really a question of if they'll develop sores, but how bad they'll be. That said, if wrapping was necessary, fine...we could deal with it. I wouldn't amputate just because I didn't want to deal with a wrapped leg for 3 weeks. That's a finite time period....amputation lasts forever.

 

 

We're willing to try bandages. We'd obviously like to save the toe. But the splint is making him very uncomfortable. Last night he was crashing into stuff with it. He barely slept all night. Just laid there with his eyes open and moved to different locations all night long. He hasn't even asked for breakfast this morning. That has not happened in the 10 months we've had him. He's really having trouble with the full leg splint. I'm ok with a wrap, just not a full-leg splint. I suspect the vet will say that the site of the fracture requires this type of immobilization. We'll see how it goes.

 

Anyone with experience with a fracture location such as this (where the toe bone goes into the foot)? It's a bad fracture, not at all clean. I do worry how it will heal. He is 3, almost 4.

[Guest Swifthounds]

If he's young and in good health and is rested enough, the bone will heal, though the trick is either being able to hold it in place with an immobilizing bandage ot having it plated.

 

The bone will have some swelling and discomfort for 6 months to a year if it's a complete break to heal. I've found that the soft tissue atrophy and scar tissue is more of an issue than the healed fracture or amp site, so no matter what route you choose, it's key that you not have lots of movement in the foot.

 

If you do need to amputate an outside toe it's not very limiting. Hounds can run just fine missing both outside toes on the same foot, they just sometimes corner differently. It's the weight bearing toes that are cause for concern.

[racindog]

This may be off the wall but that is such a tough decision-so many pros & cons for each option. Have you considered sitting down with him and explaining the situation and asking him what HE wants? If you listen I'll bet he will tell you- you'll know. You know you two communicate already. Ask him what He wants-its his foot and dogs are smart and know things we don't. JMO because thats what I would do.

[DesiRayMom]

Thinking of Kevin this morning.....hope all goes well.

[kudzu]

My girl "shattered" an outside toe on her back left foot. Shattered was the vet's term. It was the bone between the second & third joint so would that be the proximal phalanx? There were lots of little fragments & both vets felt the odds of successful surgery were very poor. If I remember correctly, their biggest concern was the possibility a fragment might shift & settle in a joint or a spot that might somehow impede function of a joint. Is it an intraphalangeal joint? (Clearly I've little knowledge of anatomy.) Heard my vet bring up splinting & other vet concurred it was not likely to get better odds than strict rest. So rest with short leash walks for potty trips only was what we did. "Keep her from running, jumping, anything that includes digging in with that toe." Not easily accomplished but somehow we managed. The bone healed with a lump & initially there were a couple loose chips. So there remained some worry of where they could end up. Months later these chips were not apparent & she's never had a problem to date with that toe.

 

All of these injuries are different, of course, and my girl's broken toe was on a back foot. Dogs carry much more of their weight on the front so I would imagine a bad back toe would be less problematic. Just thought I'd share what happened. Hope Kevin can keep his toe but I wouldn't worry much about amputation if it seemed the better longterm option. Whatever you choose, may recovery be as swift as possible with a minimum of discomfort.

[AEB]

This may be off the wall but that is such a tough decision-so many pros & cons for each option. Have you considered sitting down with him and explaining the situation and asking him what HE wants? If you listen I'll bet he will tell you- you'll know. You know you two communicate already. Ask him what He wants-its his foot and dogs are smart and know things we don't. JMO because thats what I would do.

 

Well, I told him last night I wish he could tell me what he wanted to do. He has made it clear the splint is not something he wants. He is not the same dog with it. Miserable. And he was happy going into the vet last night with his broken toe. He greeted everyone and was a total peach. None of that now. I hope we can bandage this adequately. Less than an hour until we take him in. He's crying. Can't get comfortable with his peg leg sticking out.

[Guest KennelMom]

With that type of injury, I'd want a referral to an orthopedist before deciding to amputate or try to heal it.

 

I forgot to add that I've dealt with broken toes of assorted varieties on 4 different dogs and , using a well padded bandage changed at least twice per week, have had dogs in bandages for a month plus and never had as much as the beginning of a sore. It's all in how you wrap and ventilation.

 

True. Most regular vets will wrap and say come back in a week...a lot can happen in a week! If you can manage it yourself, the odds of having better recovery and fewer or no sores is greater.

[AEB]

I think if we are considering amputating we might seek a referral. He wants to be active so in many ways his future activity and how it will be hampered by each option is a primary consideration. Our vet wants to be conservative and so Kevin is going under at 10 to get a better view of the damage and try to get it into a better position. We explained no more splint. Bandage well and if it doesn't seem to heal we'll have to consider amputating. I think he should be able to be comfortable with a bandage. He'll be much less likely to fuss and move around constantly that way.

 

One of the techs said her dog broke a weight-bearing toe last week. He is just getting Rimadyl and rest. Perhaps a bandage- it was busy and I missed that part. Anyway, no splint for him and no amputation. Just hoping it heals. And it was a bad break. He seems to be recovering. I hope we can achieve the same with Kevin.

 

Edited to add I would not feel comfortable unless he was re-bandaged every 2 days or so. A week is too long for me, as has been mentioned, a lot can happen. I should be able to handle bandage changes. I have for leg wounds, foot wounds, and unhappy tails. Granted none have involved support as an integral issue in the injury. But the vet has said I do a really nice job in the past. I hope I can rise to the occasion.

Edited October 6, 2011 by AEB

[Guest Swifthounds]

With that type of injury, I'd want a referral to an orthopedist before deciding to amputate or try to heal it.

 

I hadn't even considered taking the opinion of a nonspecialty vet (I just don't bother with them anymore), but I'm sure that's what the OP did say. I second the rec to see an orthopod before making a decision.

 

I forgot to add that I've dealt with broken toes of assorted varieties on 4 different dogs and , using a well padded bandage changed at least twice per week, have had dogs in bandages for a month plus and never had as much as the beginning of a sore. It's all in how you wrap and ventilation.

 

True. Most regular vets will wrap and say come back in a week...a lot can happen in a week! If you can manage it yourself, the odds of having better recovery and fewer or no sores is greater.

 

The only trick to it is having someone skilled show you how it's done and then executing it correctly. I had a good guide and had done it many times when Trojan broke a toe at a time when I needed to be away. It took a few practice runs, but my mom (who has always been afraid she would screw up a bandage and make things worse) did a fabulous job in my absence.

[AEB]

We'll talk to the vet after he gets a better look at it about a referral.

[Guest Swifthounds]

Give Kevin a . Poor thing.

[AEB]

Give Kevin a . Poor thing.

 

Thank you. We will. I'm sure he's getting a ton of them from his girls (the vet techs). He is worshipped there and was smothered with kisses and hugs from about 6-8 techs this morning. He actually loves to go the vet. They really are good to us there.

 

I think the vet will have a better idea in just a short time and we can decide where to go from here. I know it's a toe and we're very lucky if this is the worst thing we face with him. Doesn't make it any easier. I just want it to heal itself without making him uncomfortable. I really hope we can bandage and have it magically heal well. And, we certainly will see about an orthopedist if it seems we have to take off the toe. Steve Sarras told me of a procedure they can do and leave the pad intact but it only works for a certain type of break and I don't think this is the type. I will ask if there is something an orthopedist could do for us at this point if we're trying to just bandage and heal. Thanks everyone.

[BauersMom]

Dr Dudley at Northboro MA VCA is an excellent orthopedic vet, if you go that route.

[AEB]

Dr Dudley at Northboro MA VCA is an excellent orthopedic vet, if you go that route.

 

Thank you. I am expecting that our vet will refer to someone at Ocean State. Those are the specialists with whom he works most often. I think Northborough is about 90 minutes from us. But we will certainly keep the name. I really appreciate the reply. I don't know of any orthopedists around here but am sure they exist in our area.

[Guest KennelMom]

If you end up with a referral, it's always nice if your vet can take as many films as necessary or do any diagnostic work that might be needed and can just be sent over to the other vet...there's always a mark up on those things at the specialist

[Guest Swifthounds]

If you end up with a referral, it's always nice if your vet can take as many films as necessary or do any diagnostic work that might be needed and can just be sent over to the other vet...there's always a mark up on those things at the specialist

 

 

Not always, so you might want to ask. Both the ortho guy I used to use (now, sadly, retired) and the current emergency/veterinary specialty practice I use are actually less for bloodwork, rads, and hospitalization than any if the standard vets I've used. They are, however, also MUCH less than the other emergency/specialty places in the area, so it's not always the case.

[AEB]

My girl "shattered" an outside toe on her back left foot. Shattered was the vet's term. It was the bone between the second & third joint so would that be the proximal phalanx? There were lots of little fragments & both vets felt the odds of successful surgery were very poor. If I remember correctly, their biggest concern was the possibility a fragment might shift & settle in a joint or a spot that might somehow impede function of a joint. Is it an intraphalangeal joint? (Clearly I've little knowledge of anatomy.) Heard my vet bring up splinting & other vet concurred it was not likely to get better odds than strict rest. So rest with short leash walks for potty trips only was what we did. "Keep her from running, jumping, anything that includes digging in with that toe." Not easily accomplished but somehow we managed. The bone healed with a lump & initially there were a couple loose chips. So there remained some worry of where they could end up. Months later these chips were not apparent & she's never had a problem to date with that toe.

 

All of these injuries are different, of course, and my girl's broken toe was on a back foot. Dogs carry much more of their weight on the front so I would imagine a bad back toe would be less problematic. Just thought I'd share what happened. Hope Kevin can keep his toe but I wouldn't worry much about amputation if it seemed the better longterm option. Whatever you choose, may recovery be as swift as possible with a minimum of discomfort.

 

I think it's a proximal phalange. I know 0 about people or dog anatomy. In any event it broke at the end of the proximal phalange (up by the foot bone) (sorry, no name for that that I found yet). It might well be shattered. It is interesting to hear that the shattered toe was not a good candidate for amputation. I am hoping we don't need to go that route. Thanks for your response.

 

Thank you all for thinking of Kevin this morning. I am nervously waiting for the call and will update when i get it.

Edited October 6, 2011 by AEB

[kudzu]

It is interesting to hear that the shattered toe was not a good candidate for amputation. I am hoping we don't need to go that route. Thanks for your response.

 

Thank you all for thinking of Kevin this morning. I am nervously waiting for the call and will update when i get it.

Sorry, I wasn't specific. Her injury was not considered a good candidate for surgical repair. Since she was coping well enough going into the office, this after initially displaying sharp pain & moving three legged, they decided she was a good candidate for the wait & see approach with strictly limited activity. The vet who consulted with our vet was not an orthopod but had seen this type of injury multiple times, including a couple of his own dogs. These were primarily Disc dogs.

 

The follow up xrays showed it healing & judging from my need to keep a VERY sharp eye on my girl to keep her feet on the ground & no running we determined it was healing well. If at that point it had not been healing we would likely have been heading into surgery for amputation. My girl was only 7 or so & wasn't going to let something little like a missing toe keep her down.

 

All phalanges here are crossed for Kevin. Oh sure, we're walking funny but it's worth it if it helps.

[AEB]

Thanks everyone. We have been told it is a pretty big fracture but fairly well aligned with lots of fragments. The fracture is of p1 on 5th digit of rt front leg. Our vet wants him splinted. Said we might as well not bandage at all if we want to use a soft bandage. That it won't help much to just bandage. The splint, he says, is going to protect the foot. I told him we wanted a referral to an ortho. So he called Ocean State and we have an appointment with Dr. Sweet next Tuesday. Wish it was earlier. I don't think surgery would turn out well. But we are told they might be able to do a custom splint that would be more comfortable. I am hoping we can get a better idea of prognosis from the specialist. And, if we can get him into a more comfy splint and do frequent bandage changes it will be a much better chance for him to heal. I told the vet that if we are using a splint we are doing frequent bandage changes.

Any other advice from you guys is appreciated (as are all good thoughts). GT is such a great support!

[JJNg]

I forgot to add that I've dealt with broken toes of assorted varieties on 4 different dogs and , using a well padded bandage changed at least twice per week, have had dogs in bandages for a month plus and never had as much as the beginning of a sore. It's all in how you wrap and ventilation.

I agree with this, and I also feel the same applies to splints as well. It is possible to splint a grey's leg without getting sores if enough padding is used and the bandage is changed frequently enough. Every dog is different, but most do adjust to bulky splints, although it may take a few days before they learn to walk and maneuver with it. So even if you do have to keep Kevin's leg splinted, chance are that he will figure it out and won't stay miserable once he gets used to it.

 

We've had our share of toe issues, and the decision of how to treat and whether or not to amputated is one that depends a lot on the specific situation and individual dog. Like Heather, I personally consider amputation a last resort. But the recovery time for an amp is definitely much faster than healing a fracture or dislocation. Especially with a young, active dog, I would lean toward saving the toe if possible.

 

When Willow broke her toe chasing a rabbit in the yard a couple years ago, she was just shy of 5 years old and still active in lure coursing and amateur racing. It was the inside toe on her left front, and it was a simple, but fairly unstable, fracture (x-ray here). I chose to have the surgical specialist fix it with a screw (post-op x-ray), and it was splinted for 6 weeks. I changed the bandage/splint twice a week, and had no problems with skin irritation or sores. The bigger problem was her foot and wrist getting stiff from the immobilization, so it took some physical therapy to get the leg back to full function. Then we had to get the screw removed as it was causing some discomfort.

 

Wiki is my grey who's had constant toe problems since I adopted him. He had a front inside toe that developed arthritis from a ligament injury lure coursing, and when he dislocated the same toe at a different joint, I had it amputated (this happened a week before Willow broke her toe). The surgeon wanted it splinted for the 2 week recovery period, but I thought that was overkill, and Wiki's a bit of a klutz, so I took off the splint and replaced it with a soft bandage 2 days later. He did great with the amputation and was back to normal activity 2 weeks later.

 

Wiki competed in a few more amateur racing events after that, but unfortunately, when he's chasing a lure and it stops, he also tries to stop like a quarter horse in a reining event (imagine front legs stretched out, trying to slide to an immediate stop). He came in like this on a straight-race run last year and dislocated a middle toe on each front foot. One of these toes was the one next to the toe that was amputated. We've had chronic problems with that toe ever since, and I think because it lacks support to the inside due to the missing toe, he's been more likely to dislocate it again. Seems like he pops it back out running in the yard every few months. We've seen a rehab specialist and have used therapeutic laser and prolotherapy to try to improve stability and reduce arthritic changes in that toe. Here's what Wiki's foot with the amputated to looks like.

 

 

 

More recently, Wiki's been having problems with back toes. Within a 6 week period this summer, he managed to get this fracture on a middle toe of his right rear, and this fracture on a middle toe of his left rear. Not really sure how he did either. He might have gotten his foot caught in his crate with the first one, but he just came in from the yard limping with the 2nd one.

 

I didn't even x-ray the first toe injury and realize it was fractured until several weeks later (what do they say about the cobbler's children?), and by then he was no longer limping. I did x-ray the 2nd one right away and talked to the surgeon about it, and he suggested trying to fix the fractures with a wire or pin. But since it went through the joint, he would probably develop arthritis there either way, so I decided not to do surgery. However, the fracture didn't really go all the way through the bone and was not unstable, so I also didn't want to splint and have to deal with bandage changes, stiffness from immobilization, etc.

 

So we compromised by using a removable orthopedic splint. I would put it on when we went out for leash walks, but took it off when he was in his crate or just hanging out inside. We did this for about 4 weeks, and he's been off restriction for the past few weeks. Here are a couple photos of the splint. I used a tube sock under it for padding.

 

 

 

The toes have a firm swelling from the healing/ed fractures, and both lower joints in the toes have a decreased range of motion, but they don't seem to bother him, and he does not limp. Here's what one of the toes looks like.

 

[AEB]

We've had our share of toe issues, and the decision of how to treat and whether or not to amputated is one that depends a lot on the specific situation and individual dog. Like Heather, I personally consider amputation a last resort. But the recovery time for an amp is definitely much faster than healing a fracture or dislocation. Especially with a young, active dog, I would lean toward saving the toe if possible.

 

 

I will say you have had your share- more than your share! Thank you for such a complete post. I have a disk with the xrays and I will see if I can upload and post them. He is getting a little better at moving around. I hope that his mood tonight is from going without food for 24 hours and being under anesthesia today. I would be MORE than crabby. I will say he has only laid on the floor since we got home. Not on any of his beds. I wonder if he feels it's too hard to get comfy.

 

So, what I took away from your post is the amp you did was complication free as far as the surgery but problems later have arisen so keep the toe on if possible.

 

I wonder if there are PT exercises we can do at home when the time is right and if we can move his leg during bandage changes. I don't want him to have limited mobility because of this. I really hope to avoid it as much as possible.

 

Edited to add: that splint looks much more tolerable. And Kevin's break is definitely worse. The bone is jagged points and fragments right where his foot flesh starts.

Edited October 6, 2011 by AEB

[AEB]

Here is the patient:

 

(I hope I upload it properly)

 

Edited October 6, 2011 by AEB

[AEB]

If you're going to try to keep him splinted for a while, get your vet to show you how to do bandage changes. That will give you your best chance of avoiding pressure sores and will save you a small fortune (or maybe a large one) in vet bandaging fees.

 

The secret seems to be to add lots of padding between all toes that will be under the bandage--not just around the injured toe. Also, all around the ends of the splint.

 

See helpful posts here, here, and here.

 

And see here for suggestions on entertaining the invalid.

 

P.S. After you read these blog posts, you may opt for amputation anyway. But the bandaging advice is still valid in that case.

 

 

Kevin is crying tonight. It seems the top of the splint digs into his leg when he tries to get up (he has a hard time getting up). I stuck my finger in there and could feel the top of the splint digging-in. My only option to relieve that is to cut the vet wrap and loosen everything. I worry the splint will slip down. I also worry if I don't loosen it he will be injured. But he's happy to zip around now, now that he's getting the hang of it. I'm not sure what to do for him. I may call the ortho tomorrow and see if they have an alternative splint we can buy, but I doubt they are willing to sell us one without seeing him first.

 

 

[dmdsmoxie]

Take the toe off and this all goes away in a few weeks.

 

I can't believe the splint. That is crazy in my opinion.

[AEB]

Our vet won't consider amputation at this point. Yes, It is a crazy splint. We see the ortho on monday.