Update On Kevin's Toe

[AEB]

I do not know how to modify my post title to show there is an update. So here is a new thread. Thanks to everyone that replied!

This morning we were 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 next Tuesday. 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.

 

Kevin is back home now. He is in more pain, I think. Probably from having the toe played with earlier and the cement floors of the vet's office. (We brought a crate bed and a blanket for him. He peed on them!) He was given Rimdayl and Tramadol. We'll give him a light dinner and the lower dose of each tonight and see what happens.

I wrote our adoption group and was told that Dr. Cardosa has a lot of experience with greys. Unfortunately he is out tomorrow and so we have an appointment Monday evening.

 

[BauersMom]

Dr. Cardosa at Big River is another one of the usual orthopedics that CGA has used, but he's farther than Dr. Dudley for most of the foster homes (and also much more expensive ). But you're in good hands. good luck!

[Remolacha]

I don't know if this would work for Kevin, but both my broken toed dogs had hard rubber splints cut kind of like a half pipe that cradles the foot. They only came up to about the "wrist" (see, I know anatomy too ) It was a bit awkward, but it only took them about day to get used to walking with them on. Of course, I didn't leave them on very long, either.

 

Good luck to Kevin

[AEB]

Dr. Cardosa at Big River is another one of the usual orthopedics that CGA has used, but he's farther than Dr. Dudley for most of the foster homes (and also much more expensive ). But you're in good hands. good luck!

 

Thank you. Personal references really matter to me.

 

I don't know if this would work for Kevin, but both my broken toed dogs had hard rubber splints cut kind of like a half pipe that cradles the foot. They only came up to about the "wrist" (see, I know anatomy too ) It was a bit awkward, but it only took them about day to get used to walking with them on. Of course, I didn't leave them on very long, either.

 

Good luck to Kevin

 

Thank you for the suggestion. Are they something carried by vets? I am learning a lot here- never dealt with a broken anything before. Anyhow, I really hope that they will be able to make him more comfortabe. That and the prognosis is what we're after. We really don't want to put him through surgery. We haven't heard much good about toes and surgical mending.

[AEB]

The patient:

 

[gazehund]

Awwww look at the handsome boy! Good to know Kevin is in such good hands. Please keep us posted on his progress.

 

Only supporters can modify a topic title.

[AEB]

Awwww look at the handsome boy! Good to know Kevin is in such good hands. Please keep us posted on his progress.

 

Only supporters can modify a topic title.

 

Thanks for the info Nancy.

 

And thank you- we tell him all the time how handsome he is (sound familiar?). I will keep this thread updated.

 

We're going to give him his meds soon and I hope he'll be more comfortable. I have never given tramadol but understand it to be quite powerful. So he's going outside to potty in case he zonks-out.

[Guest madredhare]

We did the whole splint thing two years ago. Went for daily splint changes for six weeks. It was kind of costly, but so worth it. I was so afraid that Sadie would get sores under there. My vets were wonderful with us. We managed to just have a small pressure sore on the side of the foot toward the end. Good luck!

[Remolacha]

I was hoping I could find a link with a picture, but no luck. I don't think this is something my vet "made up", but you never know

[EllenEveBaz]

Wow -- that is some splint. Poor handsome boy.

[KF_in_Georgia]

If Kevin pants a lot on the tramadol, don't assume it isn't working and he's in pain. Some dogs get a bit anxious and pant while on tramadol. If it happens to Kevin, talk to your vet about a substitute painkiller.

 

Some dogs, on the other hand, barely blink under tramadol. (My Sam is that way.) When tramadol works, it's great, but for some dogs--in some cases--an alternative is more useful.

[racindog]

[AEB]

Thank you everyone! Yes, it's a lot of splint and it makes me uneasy. I want to have it changed every couple of days at a minimum. It won't be changed until Monday night. At which point I will ask to be taught by the surgeon. I do worry it's too tight and digging into his leg at the top. I tried to stretch the vet wrap there some. I hope it helps. I know if I cut it it could slide around and cause a sore. This is essentially a cast for all intents and purposes. Tightly applied- which makes me nervous.

 

But how do i know I need to bring him over to the vet today or tomorrow for a change or if he'll be ok until I see the surgeon? I think everyone thinks I am crazy being so worried about this. I get nauseated thinking he's in pain.

 

Tramadol- he was a little weird last night. LIke he didn't want to be touched and his skin was crawling. Very odd for him. I wondered if there were some lingering effects of the anesthesia. His tummy was a mess too. Today we had a full meal and I think he slept a few hours (he's probably not himself because he got little sleep in the last couple days and he usually gets 20 hours or so everyday). I think he feels better than last night. But he is still not dozing- just laying there staring. He is on 50mg tramadol 1-2 pills, 2-3x a day (and rimadyl). He's had one tramadol with his rimadyl today. I am considering giving him another (it's been 4 hours). How do I tell if I need to get him something else? He panted some last night but he's panting excessively. He is not sleeping though and I thought (hoped) it would knock him out. Maybe it's giving him only 50mg instead of 100? I am not sure if we are ok where we are, need to give more tramadol, or need to switch to something else. Will he adjust to the Tramadol if that's what causing his behavior?

 

I am also thinking that if we have to go out we might bring him with us so we can keep an eye on him. PLus it's something a little different. He usually gets at least one interesting adventure a day. And now he's just miserable. But, take him out front to potty and he perks right up and wants to go for a walk down the road. He is learning to zoom along. So he was allowed to go to the next driveway last night. It gets some energy out without him going so far that he gets tired and touches the splint to the ground.

 

Remolacha- check the original thread- there was a pic posted yesterday and I think that splint is like what your pup had.

 

I will need to decide on the tramadol/meds and any bandage changes today. Vet is only open until 12 tomorrow.

 

THis whole thing is exhausting for all of us- partly my own fault for worrying about whether his leg will fall off from tight bandaging. Thank you again everyone for all your input! April & Kevin

[TheFullHouse]

Bullitt broke 2 toes when he was about 6 months old and wore a splint like that. He had weekly bandage changes and had no problems at all. Hope Kevin heals quickly.

[AEB]

Bullitt broke 2 toes when he was about 6 months old and wore a splint like that. He had weekly bandage changes and had no problems at all. Hope Kevin heals quickly.

 

Thank you so much for your reply Judy! How many weeks was he in it? No atrophy?

 

It's good to know they can have a splint like this without complications.

 

Did Bullit's splint feel really tight across the top of the splint, like it might cut into his leg?

Edited October 7, 2011 by AEB

[Remolacha]

Yes, that splint (in the other thread) is very similar. We didn't have the nifty straps, though I still changed the bandages every other day. I think Sallie (with the bad break) wore it about 2 1/2 weeks. No sores.

[AEB]

Yes, that splint (in the other thread) is very similar. We didn't have the nifty straps, though I still changed the bandages every other day. I think Sallie (with the bad break) wore it about 2 1/2 weeks. No sores.

 

Thanks, I will bring a picture of that one in with me. I am worried about him this morning. He more whiney and his leg is hot. Is that normal because it is wrapped? Or should I be seeing about a bandage change at our vet today?

[Remolacha]

I don't think it should be hot, but as long as it's not swollen, it's probably ok. I forget, how long has he had it on?

[AEB]

I don't think it should be hot, but as long as it's not swollen, it's probably ok. I forget, how long has he had it on?

 

Well, he has had a splint on since about 6pm on Wednesday. He has had this one on since thursday around noon.

 

It's not swollen.

[BauersMom]

Is he still using the leg as much as before? Does he seem more uncomfortable?

 

My usual indicator of something going awry is when they limp more/use the leg less than when the splint first went on or if they are licking or chewing at the wrap... I typically err on the side of caution and will re-wrap it at any sign of an issue, but with that monstrosity, you'd have to take him to the vet to do that so I don't know what to suggest to you. It'll be an expensive e-vet trip if it's nothing, KWIM?

 

Does the splint smell OK?

[AEB]

Is he still using the leg as much as before? Does he seem more uncomfortable?

 

My usual indicator of something going awry is when they limp more/use the leg less than when the splint first went on or if they are licking or chewing at the wrap... I typically err on the side of caution and will re-wrap it at any sign of an issue, but with that monstrosity, you'd have to take him to the vet to do that so I don't know what to suggest to you. It'll be an expensive e-vet trip if it's nothing, KWIM?

 

Does the splint smell OK?

 

No, no smell. He's pulling at the top of the cotton and vet wrap. Just there. Seems to have a bit more room on top than it did, which is probably good. He's learned to move on 3 legs and wants to go for huge walks but we are doing just enough to keep his energy levels in check. He's learning to put his peg leg down and to skip along. And to rest on it for balance. Tonight he's whining because he wants to lay around outside and we can only lay around so much. He vocalized a little tonight, which I haven't heard since Wednesday. So he's acting like himself. Excited for walks to potty. Excited for food. So, he seems ok. But bored and frustrated with the wrap. Two more days and he'll get a change. I hope to a new splint. No swelling (or at least not a noticeable amount). So I am going to keep my fingers crossed it's just annoyance and everything will hopefully be ok. I'd get a little crazy too if my arm or leg were out straight like that for days. I am feeling very grateful these past few days for the ability to bend my appendages.

 

Emma, what does KWIM stand for?

[BauersMom]

Kwim - know what I mean.

[KF_in_Georgia]

I know you saw Jen Bachelor's blog about bandaging. Did you also see her posts about entertaining invalids? Her Riley is recovering from a broken hock, and Jen has had to restrict Riley's activities. They've worked on unusual training tricks to keep Riley entertained.

[Guest LindsaySF]

I'm glad you're seeing an ortho for an opinion.

 

With the vet mentioning fragments being present from the break, that makes me wonder whether this break will be able to heal without surgery. Usually fragments need to be removed/moved, unless they are all conveniently in a row where the bone is supposed to be. If they suggest surgery on the toe, honestly I would go the amputation route, especially for an outer toe. I'd be more likely to try to save a weight-bearing toe and try all sorts of screws/pins, but I wouldn't bother with all that for an outer toe.

 

Splints on Greyhounds also make me very nervous, and I try to avoid them when possible (seen too many sores, sad to say). Even the ortho we use avoids hard splints/casts whenever she can, she prefers lighter bandages when possible. My rule of thumb about splints too, when in doubt, have it changed. Might cost you extra money and some driving, but don't go the "wait and see" route with a splint.

 

If you need to immobilize the toe/leg, I would look into a removable splint. Try handicappedpets.com. The idea is to have the dog wear the splint when walking/moving around, but you can take it off when they are resting (might need to crate them). The exact type of injury will determine whether or not a removable splint will work for you. I've seen these splints a lot for leg injuries, not so much for toe injuries.

 

ETA: Big splints like that one can sometimes cause muscle atrophy and tendon issues. We've gotten some broken leg dogs in that were splinted too long, their toes were never the same (curled under, etc). Of course it depends how long the splint is on. I would ask about P/T to avoid that. Also, I personally would not want my dog's "wrist" immobilized with a big splint if it wasn't necessary. Is there a different way to splint it that still immobilizes the toe, but leaves the wrist free?

 

Good luck.

 

 

 

~Lindsay~

 

 

 

 

 

Edited October 9, 2011 by LindsaySF

[AEB]

I'm glad you're seeing an ortho for an opinion.

 

With the vet mentioning fragments being present from the break, that makes me wonder whether this break will be able to heal without surgery. Usually fragments need to be removed/moved, unless they are all conveniently in a row where the bone is supposed to be. If they suggest surgery on the toe, honestly I would go the amputation route, especially for an outer toe. I'd be more likely to try to save a weight-bearing toe and try all sorts of screws/pins, but I wouldn't bother with all that for an outer toe.

 

Splints on Greyhounds also make me very nervous, and I try to avoid them when possible (seen too many sores, sad to say). Even the ortho we use avoids hard splints/casts whenever she can, she prefers lighter bandages when possible. My rule of thumb about splints too, when in doubt, have it changed. Might cost you extra money and some driving, but don't go the "wait and see" route with a splint.

 

If you need to immobilize the toe/leg, I would look into a removable splint. Try handicappedpets.com. The idea is to have the dog wear the splint when walking/moving around, but you can take it off when they are resting (might need to crate them). The exact type of injury will determine whether or not a removable splint will work for you. I've seen these splints a lot for leg injuries, not so much for toe injuries.

 

ETA: Big splints like that one can sometimes cause muscle atrophy and tendon issues. We've gotten some broken leg dogs in that were splinted too long, their toes were never the same (curled under, etc). Of course it depends how long the splint is on. I would ask about P/T to avoid that. Also, I personally would not want my dog's "wrist" immobilized with a big splint if it wasn't necessary. Is there a different way to splint it that still immobilizes the toe, but leaves the wrist free?

 

Good luck.

 

~Lindsay~

 

 

 

 

Yes, I read about entertaining the invalid. And we are massaging him and taking him places. We will do some training too. We are allowing him to use his potty trips to get a little exercise. He zips around now and when doing potty breaks he's dragging me. I think he now goes faster on 3 legs than 4. He is acting more himself, which makes me happy.

 

Splint- I don't want that on for any lengthy period for the reasons you mention Lindsay. We see the ortho tomorrow evening. So we'll get that splint off then, I hope, or at least a bandage change. My vet thinks the leg needs to to be immobilized above the wrist till the bones get a "fiberous union". So until tomorrow I can live with it because he's being himself and moving around well and ill have been in it five days. Four days in that bandage. I figure if he pulled tendon in the process it might be good for it to rest for a few days. But I want something to change tomorrow. I don't like this splint. That's one of the major motivations for seeing an ortho, plus to get a prognosis. The vet said the pieces are well-aligned. So I am hoping we can save the toe, but I know we may need to remove it. My priority is his comfort and getting something where he can move that leg more so the muscle doesn't atrophy.