Another Toe Situation

[Trihounds]

Thanks to the Kevin thread (and others) with feedback from AEB, LindsaySF, Swifthounds, Dick, Batmom and a ton more, I've learned about the pros and cons of treating a broken toe and the various methods.

 

Last night, Bumper broke the outside toe on his front left leg and we have no idea how. We just opened up (fenced) the 'back forty' for the hounds and it is possible he did it back there. The vet indicated his type of break is consistent with him catching his toe on something (ie: outside of a hole if he stepped in one, on a rock, sapling, etc. He's got long toes so I can see how that could happen. His break is almost identical to jjng's Wiki, in that it is the bone closest to the foot and longitudinal in nature. It's a clean break so there is no offset and it ends just before the joint; but it's a long one.

 

When Bumper came in last night, he was limping but not crying. I gave him 2 Tramadol and we went to bed and by this morning, his foot had really swollen up. As he is on Dexamethasone for an autoimmune condition, we can't give him anti inflammatory's (like Rimadyl) so I knew all a vet could do was manage pain...with Tramadol. We pre-empted that, gave him the Tramadol at home and took him in at 11:00 this morning.

 

Despite all my questions and comments about a soft / short splint (thanks to you all), the vet indicated, in her experience, the full splint is the way to go in the beginning for his type / location of break. We will change the splint/bandage in 1 week and i) assess how Bumper manages with what is really a solid 'cast' on his front leg for the week and ii) see if there are any sores or beginnings of problems created by the long splint. There is space at the top and he has plenty of padding between his toes so every attempt at eliminating friction was made up front. He is 7 and pretty lazy so we don't anticipate problems of the exercise kind. We'll assess going to a short splint if needed next week.

 

For now, his toes are well padded and he is certainly not pleased with the thing. He needs to figure out how to walk/lay down with it on and to make all of our lives just that much more miserable, he has a weak hind end / coordination issues as a result of a spinal problem, thanks to the autoimmune thing. So, he's almost bipedal .

 

As far as meds, he is on Dex for life and that has some anti inflam properties but his dose is one of 'maintenance' versus something to target swelling. 100 mg of Tramadol 3x daily and we can add Gabapentin if needed (have that on hand as well). And Cephalexin as an antibiotic.

 

I really did learn a lot from the toe threads and know there is no easy or one size fits all way out of this, but with your experience, I know what I'm looking out for and we can change paths accordingly if we need to, so thank you! This is the power of GT!

 

Thought I'd share the homecoming experience with you, so you can see the massive boat anchor Bumper has tied to his body:

 

Being checked out by his bro from the same mo (notice his long toes on right foot):

 

Literally being laterally supported by Brucie as he wonders what to do:

 

Given he did nothing but look pathetic and helpless, I picked him up and laid him down on the bed so he could get comfortable (as much as possible with a boat anchor):

 

I'll be moving into the family room to sleep with him for the next while as he isn't great coming down stairs on the best of days. At least I am close enough to the fireplace to keep it nice and toasty for us. Please send him whatever good wishes and luck you can spare!

 

++++++++++++++ Update Nov 22, 1 week after break +++++++++++++++++++

 

A quick update: So far so good.

 

Bumper has finally figured out how to walk on the splinted leg and is using it appropriately. He doesn't tire like he has been for the last week and is able to make the short jaunt to the bus stop to drop off and pick up the girls, something he knows is coming in the minute before we start getting ready every day.

 

 

We did the splint change today and thankfully it was as perfect as it could be. There is no sign of anything problematic or concerning and the vet asked to see us again in 2 weeks. If we see Bumper taking a keen interest in the splint, we'll have him back riteawayquik! I asked the vet to shorten it, and she did. She also wrapped it a little thinner so it isn't quite as heavy - as 'anchorous' as it used to be!!

 

Thanks as always for the helpful tips. We aren't across any finish line yet, but the boy is off to a great start. He's also sporting a new, vibrant red with 2 athletic stripes

 

Edited February 1, 2012 by Trihounds

[duncan41]

Awww! Poor Bumper! Hope he heals riteawayquik ( Hi, Piper!). Love the boat anchor analogy - and he does look quite helpless!

[heartdogs]

Poor Bumper! That really looks uncomfortable-bet he milks it for all it's worth. At leaset his brothers is kind to him unlike some girls I have.

[TwiggysMom]

Ohh, the poor puppy! He looks so sad about the "cast".

 

I have no experience with going through healing a toe injury, but my various experience with dealing with healing injuries/surgeries tells me that if he starts pestering it more or panting, bring him in early 'cuz there's probably something going on.

 

Sometimes I wonder if they couldn't just somehow "sling" the leg and make them tripod it for a while while these toe injuries heal. (I'm not the brightest bulb in the chandelier, so I'm sure that's a bad idea, but still I wonder...)

 

Give the poor boy a cookie or at least a smooch from me.

[Batmom]

Aw, poor bug. Hope he heals quickly and well!

[BatterseaBrindl]

Awwwww....poor Bumper.

Sending lots of healing thoughts

[4My2Greys]

Nadir had to wear a splint like that when he broke his toe about this time in 2009. One word of advice is pay close attention if he gets obsessive about licking at the cast. Nadir started licking around the top near the elbow. If thought he was doing it because his leg was itching from being in the cast. When I muzzled him so he could no longer lick at it I learned the next morning from awful smell that his leg was infected. The smell of rotting flesh was so horrible that driving to the vet I feared he was going to lose his leg. When they took the splint off there was a deep hole in his elbow where the splint had rubbed the elbow raw and caused a wound that had gotten infected. That happened within 8 days of having that splint on.

[Remolacha]

Poor Bumper, that is a huge cast! When Molly broke her outside front toe she was in a much smaller cast, didn't go all the way up. She tolerated it for 3-4 days, then insisted I take it off Vet OKed it, just said to make her take it easy. When Sallie broke her toe, it stayed in a cast longer (inside toe, bad break) and she did get some sore spots from the rubbing.

 

The two worst things about toes are the risk of sore spots from the cast rubbing and getting infected, and it takes so dam long for the toes to heal. Months!

[mychip1]

Good thoughts your way!!!

[Trihounds]

Nadir had to wear a splint like that when he broke his toe about this time in 2009. One word of advice is pay close attention if he gets obsessive about licking at the cast. Nadir started licking around the top near the elbow. If thought he was doing it because his leg was itching from being in the cast. When I muzzled him so he could no longer lick at it I learned the next morning from awful smell that his leg was infected. The smell of rotting flesh was so horrible that driving to the vet I feared he was going to lose his leg. When they took the splint off there was a deep hole in his elbow where the splint had rubbed the elbow raw and caused a wound that had gotten infected. That happened within 8 days of having that splint on.

 

 

Poor Bumper, that is a huge cast! When Molly broke her outside front toe she was in a much smaller cast, didn't go all the way up. She tolerated it for 3-4 days, then insisted I take it off Vet OKed it, just said to make her take it easy. When Sallie broke her toe, it stayed in a cast longer (inside toe, bad break) and she did get some sore spots from the rubbing.

 

The two worst things about toes are the risk of sore spots from the cast rubbing and getting infected, and it takes so dam long for the toes to heal. Months!

 

This is great advice and I know others have had the same (unfortunate) experience. We'll be watching closely....things look nicely padded on Bumper and I also don't see him terribly active. I think he wonders what gobbled his leg up as he won't even lift it!! I think he is waiting for a hooman to do the work!!! (but he has to learn how to get around!).

[4My2Greys]

 

This is great advice and I know others have had the same (unfortunate) experience. We'll be watching closely....things look nicely padded on Bumper and I also don't see him terribly active. I think he wonders what gobbled his leg up as he won't even lift it!! I think he is waiting for a hooman to do the work!!! (but he has to learn how to get around!).

 

Would you believe Nadir jumped up onto my bed, which is somewhat high, with that splint on. He also moved better on "walks" with the splint on if he was running. As long as his foot remained wrapped in that splint or later a shorter one I let him move like this, however when it came off it was strictly walking only and did that I'm thinking for 3 months. The toe healed nicely and hasn't given him a bit of trouble since. I hope Bumper's does as well. Nadir would like to add that some extra cookies and a bit of ice cream help in the healing process.

[Guest BrianRke]

Awww, poor guy. That is a giant cast. I hope he recovers quickly.

[Charlies_Dad]

Wow, that is big! Would not have thought it would need to be but I could easily see Bumper making it worse if it wasn't. This way he will not be able to explore the 'back 40' so easily. Hopefully he mends quickly.

[racindog]

[kudzu]

Poor, poor Bumper. Sorry dude. That really sucks. I am so thankful my vet didn't try to splint Venus for her shattered toe. Blessedly it healed very well with strict rest only. As you said though, it isn't one size fits all. All dogs & injuries are different.

 

Good luck, Bumper. Heal fast.

[sweetdogs]

Aw Bumper, it's good to see your handsome self but your anchor doesn't match your sails! When you need a re-wrap, make sure they fix that.

 

I hope you heal up really quickly.

[DesiRayMom]

Aw, poor, pitiful boy. Extra cookies, please. Hoping that toe heals fast.

[Guest goofydog]

Work it for all the extra cookies you can Bumper! I hope you're feeling better soon.

[Trihounds]

Progress update:

 

Well, my suspicion is the 100 mg Tramadol 3x a day is making Bumper a bit shaky and potentially hallucinogenic. He'd wake up at night screaming for nothing and then doze back off (more than he has occasionally done in the past). I can't see how there could be any movement or bumping of his toe whatsoever, so I skipped the Tramadol this morning and gave him only the antibiotic. So far, he is more lucid and 'present' without the pain meds and no drawbacks so far.

 

For whatever reason (he is very stubborn), he is not using the wrapped leg - not even for support. It kind of drags beside him as he hobbles on 2.5 remaining legs. He is ok walking in the grass outside by himself but needs assistance on stairs and our wood floors. Let's say he's spent 99% of his time lying down in the bed I've made for us in the family room. Not the first time I've had to relocate out of a real bed to stay with him for an extended period, but the lack of sleep reminds me of when our kids were babies.

 

I plan to strongly push for a shorter splint at the change next week, at least to try that for a week and see how he does. Being at his side whenever he gets up isn't practical over several weeks.

 

And thank you for the well wishes!! Here is the boy this morning, making better use of his anchor:

 

[XTRAWLD]

Oh my gosh, the poor guy! Lots of thoughts and prayers over here for speedy recovery!

[AEB]

I am so sorry I missed this thread! Poor Bumper. How's he doing?

 

You know that I understand. Based on my experiences I will make a suggestion. Get the splint change at 3 or 4 days instead. Call your vet and ask if they can make a custom fiberglass one. Kevin had a splint just like that for 5 days. It was changed to the custom fiberglass splint. It was supposed to be changed but when we went back, he had a sore between his toes. That was a Monday. And then of Friday he had developed that horrible sore. If you get him a custom fiberglass one you can ask that they put a couple layers of tough med tape on all edges. and then pad everything really well. Have them show you how to change it. Buy a ton of supplies from them and change it every couple days. Those sores can develop so fast. He might be fine with a splint (a custom one). Kevin had a rub spot. That's what caused it. I assume something wasn't properly padded. I think it's great they started him on anti-biotics already. If he does get a sore it should not get as bad as Kevin's. But you really need to be looking at that leg every couple days.

 

If you get the answer that your vet can't do a custom splint you can then find an ortho. You don't want to let a week go by. Good luck to you and Bumper!

[GreytHurleyDawg]

Woodie had a middle toe (that had previously been dislocated and then suddenly was broken, probably from running around in the yard too much) that broke in a FEW places! The vet wrapped him all the way to the knee and Woodie walked around like a peg-legged pirate for 2 weeks, clunking all the way. The first 12 days or so were fine and we went in early for the 2 week bandage change. At that point, things changed RAPIDLY! He began chewing at it and then it became an obsession. He was eating food and stopping to chew at it.....we tried to tell ourselves he was just itchy. It turns out he had a huge ulcer under his dewclaw!!!!!! We got antibiotics and then they wrapped it up the same way again. The tech did say we could cut it open if it seemed to swell or itch above the paw. We finally couldn't stand it when he started to itch again. this was on a Saturday afternoon. We waited until Monday morning and got to our regular vet. He had another ulcer on top of his paw so he only obsessed when it truly was unhealthy. We literally walked in and said they HAD to remove the bandage because we were worried he would lose the leg over this one toe.

 

Fortunately, xrays revealed a healing callous on his bone and they sent him home unwrapped. He still has no fur on those two ulcers from the end of September.

 

I agree to be careful!! Our initial goal was to keep it splinted for a month. He made it about 3 weeks.

 

[TheFullHouse]

Poor guy, hope he recovers quickly.

[Trihounds]

I am so sorry I missed this thread! Poor Bumper. How's he doing?

 

You know that I understand. Based on my experiences I will make a suggestion. Get the splint change at 3 or 4 days instead. Call your vet and ask if they can make a custom fiberglass one. Kevin had a splint just like that for 5 days. It was changed to the custom fiberglass splint. It was supposed to be changed but when we went back, he had a sore between his toes. That was a Monday. And then of Friday he had developed that horrible sore. If you get him a custom fiberglass one you can ask that they put a couple layers of tough med tape on all edges. and then pad everything really well. Have them show you how to change it. Buy a ton of supplies from them and change it every couple days. Those sores can develop so fast. He might be fine with a splint (a custom one). Kevin had a rub spot. That's what caused it. I assume something wasn't properly padded. I think it's great they started him on anti-biotics already. If he does get a sore it should not get as bad as Kevin's. But you really need to be looking at that leg every couple days.

 

If you get the answer that your vet can't do a custom splint you can then find an ortho. You don't want to let a week go by. Good luck to you and Bumper!

 

 

Woodie had a middle toe (that had previously been dislocated and then suddenly was broken, probably from running around in the yard too much) that broke in a FEW places! The vet wrapped him all the way to the knee and Woodie walked around like a peg-legged pirate for 2 weeks, clunking all the way. The first 12 days or so were fine and we went in early for the 2 week bandage change. At that point, things changed RAPIDLY! He began chewing at it and then it became an obsession. He was eating food and stopping to chew at it.....we tried to tell ourselves he was just itchy. It turns out he had a huge ulcer under his dewclaw!!!!!! We got antibiotics and then they wrapped it up the same way again. The tech did say we could cut it open if it seemed to swell or itch above the paw. We finally couldn't stand it when he started to itch again. this was on a Saturday afternoon. We waited until Monday morning and got to our regular vet. He had another ulcer on top of his paw so he only obsessed when it truly was unhealthy. We literally walked in and said they HAD to remove the bandage because we were worried he would lose the leg over this one toe.

 

Fortunately, xrays revealed a healing callous on his bone and they sent him home unwrapped. He still has no fur on those two ulcers from the end of September.

 

I agree to be careful!! Our initial goal was to keep it splinted for a month. He made it about 3 weeks.

 

Thanks for the input - I know....it makes me nervous having this thing on. I'll take him tomorrow or Tuesday to see how things are going. Bumper is still not using the leg which makes me wonder how there could be any rubbing if it floats through the air when he walks? I know they've really padded between the toes and kept things stable inside, so I'm hopeful he won't have any sores at all. If he does, there is no question we'll stop the long splint immediately. Your warnings have been heard and we definitely don't want problems secondary to the the original treatment!

 

So far, the boy has left the splint completely alone - no licking, nothing. Trusting this is a good sign....

[4My2Greys]

 

So far, the boy has left the splint completely alone - no licking, nothing. Trusting this is a good sign....

 

I think that's a pretty good sign he's not having any problems with the cast. If they put another long splint on make sure they put sufficient padding not only around the toes, but also at the top in the region of the elbow , that is where Nadir's ulcer developed.