Trouble Healing From Fractured Tarsal

[Guest Wasabi303]

Wasabi fractured her right hind tarsal bones in October. She had surgery to place in a plate and several screws.

 

 

 

 

The surgery was on October 27th, almost exactly 9 weeks ago. Wasabi was in a splint for a few weeks and a soft bandage for a few weeks, and she had started putting weight on the leg and going on short (about 2 blocks) walks. Then, one week ago, she knocked her food bowl over and spooked herself. I did not see it, but I think she backed up quickly and put weight on the leg. Since then, she has been hesitant to put weight on the leg. I give her some Tramadol (sp?) and she gets better over a few days, and then she will slip again. This has been happening consistently ever two or three days. We have stopped trying to walk, and I have wrapped the leg in an ace bandage fro support.

 

I am feeling pretty hopeless at the moment. She just slipped again tonight when we went out to go pee. She stood there screaming and crying for about 5 minutes before I could move her inside. I don't know what to do. She will never heal if she keeps slipping, but she has to go outside to go to the bathroom. I am not sure if she damaged the plate/screws at some point, but I cannot afford another surgery.

 

Anyone have experience healing from this type of surgery? Suggestions?

[tbhounds]

I'm sorry but she needs to be seen by the orthopedic vet again. After 9 weeks that should be healed. If you would like another opinion you could consult with Dr Couto and while he's not an orthopedic vet he can consult with a really top notch one. You would need to send a brief history with surgical records and images.

 

http://www.coutovetconsultants.com

[Guest Wasabi303]

I am planning on going in for an x-ray after Christmas. Please cross your collective fingers for good news, although I have no idea what that would be.

[tbhounds]

Bones or plates could have shifted., infection and even cancer could be causing the pain. If she's that painful I would have seen her earlier (I know it's expensive) but, at this point something could be potentially very wrong. Could they see you today?? Be very, very careful wrapping that leg with an ace bandage-if it is tighter than it should be you can do more harm than good. Please call your vet today.

[Guest Wasabi303]

It is not cancer, she is only 2 1/2 years old. I have been in contact with my vet all week and I have been following their recommendations. I will get her in for an x-ray as soon as I can. I am perfectly aware of the dangers of poor wrapping, I have been wrapping horse legs for 16 years.

[tbhounds]

It is not cancer, she is only 2 1/2 years old. I have been in contact with my vet all week and I have been following their recommendations. I will get her in for an x-ray as soon as I can. I am perfectly aware of the dangers of poor wrapping, I have been wrapping horse legs for 16 years.

 

I'm not sure why you are posting asking questions then. She hurts, something is obviously wrong, she's needs to see the vet. Fwiw-while unlikely young dogs get cancer too :-(

[forevergrey]

Here is hoping for good news for your girl. Hopefully it's something that can be easily remedied without being cost prohibitive. I do agree with tbhounds, sadly I have seen postings on greyhound groups about young dogs getting osteo. But it is still not terribly likely!

[Guest Wasabi303]

I appreciate the information so far.

 

My main question is whether other people have experienced set backs in the healing process similar to this. Are set backs normal?

 

I am also wondering if my vet did the right things? It seems like we took the splint/bandage off too soon if such a small thing could screw it up.

 

I am also wondering why i spent so much money on the surgery that has ultimately failed. Would it not have been better to just put a splint on and let the joint fuse?

Edited December 24, 2014 by Wasabi303

[NeylasMom]

I think anything that is that painful is not "normal". I hope.you can get her in for that x-ray very soon. Has your vet offered the option of additional pain medication in the meantime. Adding Gabapentin at a low dose might be a.good idea, 100-200 mg every 6-8 (of course follow your vet's advice, but that would be a typical dose).

[forevergrey]

My 4 year old boy fractured his metacarpal bone two years ago while running. He was in a split for 4 weeks, with weekly splint changes, (at one point he managed to somehow break the splint). Then another 4 weeks with just a soft wrap. Then another 8 weeks without anything on his leg but still very short (around the block to potty only) walks. I also live in a walk up three flights and had to carry him up and down every time he needed to use the bathroom. I took it very slow and then finally we were able to go back to normal walks. He was lame the first week or so but slowly came back to normal. I was giving him pain meds (mostly NSAID's) twice a day for the entire duration of his healing process. He has healed completely and is back to normal but it took two months. I suppose his break was not too bad since the vet did not feel the need to add any hardware-just the splint.

[Batmom]

She needs an x-ray, pronto.

[cristar]

X-ray, definitely.

As soon as possible.

[galgrey]

She needs an x-ray, pronto.

[BatterseaBrindl]

Agree... the dog needs to be seen ASAP.

 

Are you still away on your trip?

Was she like this when you left?

Did your vet say it was fine to travel with her in so much pain?

 

There must be an Emergency vet wherever you are.

Please take her ......

[JJNg]

Sorry to hear about Wasabi's setback. If her surgery was Oct 27th, by my count, that was only 8 weeks ago on Monday. So it would have been about 7 weeks post-op when she knocked her food bowl over. If the bone was mostly healed, as it should be by 6-8 weeks, the plate shouldn't have been bearing much of the weight of her leg. So hopefully she just tweaked it, and since it's only been a week, she may just need a little more time to recover from that.

My question is, why does she keep slipping? Do you have slick floors? Does she seem to be having more trouble maneuvering now than she did for the first few weeks post-op?

I do agree that an x-ray would give you the most information about what's going on in terms of the original fracture healing, how well the repair held, and whether she did any damage when she hurt it. Has she had any follow-up x-rays taken since the surgery?

I had a foster who was recovering from a bad hock fracture, and he would occasionally bang the leg if he slipped or lost his balance. He'd scream for 30 sec, hold it up for a bit, but then he'd be walking on it again after 10-15 min.

Regarding your other questions...I don't think your vet did anything wrong. If a fracture is internally stabilized with hardware, a splint often isn't even necessary. The foster I had was one of the worse I've seen (completely dislocated along with the broken tarsal bones), and the surgeon sent him home with only a soft bandage immediately after surgery. We kept it bandaged for 2 weeks, and then left it unwrapped once the incision was completely healed.

Also, please don't second guess your decision to do the surgery. With a hock fracture, surgery is often the best way to achieve the best healing for a fully functional leg. I've seen dogs that are only splinted that don't fuse properly, and the joint is unstable and the dog is unable to put full weight on it. Unfortunately, even with everything done right, complications can occur. Hopefully, Wasabi's issue is a minor one.

[Guest Wasabi303]

Are you still away on your trip?

Was she like this when you left?

Did your vet say it was fine to travel with her in so much pain?

 

Yes we are still away from our home location, and yes she slipped the week prior to our trip, but she was not in any pain and was beginning to walk on it again the day we flew. So no, I did not take a screaming in pain dog through the airport and frankly, I resent the implication. She had a full exam 3 days prior to our trip and was cleared to fly. It is just today that she escalated to the level of 'screaming.'

 

 

My question is, why does she keep slipping? Do you have slick floors? Does she seem to be having more trouble maneuvering now than she did for the first few weeks post-op?

 

I do agree that an x-ray would give you the most information about what's going on in terms of the original fracture healing, how well the repair held, and whether she did any damage when she hurt it. Has she had any follow-up x-rays taken since the surgery?

 

Thanks so much for your response, this makes me feel a lot better. To answer your questions: I honestly think it is bad luck and unavoidable circumstances that she keeps slipping. It is always a relatively minor little mis-step, usually when she squats to go potty, when she looses her balance and has to put more weight on the injured leg. We are in a strange place, not her normal potty yard, so that doesn't help. She has had a follow up x-ray at 7 weeks, and everything looked good.

 

Her pain is under control and she is getting tons of assistance moving around/eating/peeing. We are going to the vet Friday morning.

[tbhounds]

Update on your girl??

[BatterseaBrindl]

 

Hope she is OK.....

[Guest Wasabi303]

Update: Wasabi and I went to a vet and got an x-ray. GP vet did not see anything abnormal and gave us stronger pain meds, said something about a strain. I was not impressed. Same vet calls me later that day (Friday) and says that her radiologist saw shadows on the xray that suggest the screw might be moving. Said that an orthopedic surgeon she called as a consult told her the leg needed to be stabilized right away.

 

I took Wasabi in and got her a fiber-glass cast. Asked the orthopedic surgeon who put it on what he thought of the x-ray, he said didn't see anything unusual, but trusted the radiologist.

 

Called my own orthopedic surgeon and left a message asking what I should be doing, but he is out of town until Jan 5th. In the mean time, she has the cast, I am giving her pain meds and we are taking it easy. She seems completely unperturbed by the whole ordeal, definitely more confident with the cast on.

 

All this is to say that I am utterly confused. We have not completely ruled out infection, but every vet that I talk to says that it is unlikely.

[JJNg]

What are your instructions for how long she's supposed to wear the cast? I'm not a huge fan of fiberglass casts in greyhounds as they commonly cause pressure sores. I much prefer splints that can be changed a couple times a week. Unless they cut the cast so that it can be removed and re-wrapped periodically to check the leg?

[tbhounds]

What are your instructions for how long she's supposed to wear the cast? I'm not a huge fan of fiberglass casts in greyhounds as they commonly cause pressure sores. I much prefer splints that can be changed a couple times a week. Unless they cut the cast so that it can be removed and re-wrapped periodically to check the leg?

I thought the same thing. Could be exchanging one problem for another. I have had fiberglass cast bi-halved to make for frequent changing.

[Guest Wasabi303]

Unless they cut the cast so that it can be removed and re-wrapped periodically to check the leg?

 

That is exactly what they did. I am supposed to change it every week. I have not yet heard from our surgeon so I don't know how long she is supposed to where it in total, but I am guessing 4 weeks.

[JJNg]

Glad to hear they have it set up so you can change the cast. Personally, I'd change it twice a week. Pressure sores can develop in a matter of days and be pretty bad by a week. If the cast covers her toes, make sure you put cotton between her toes. Sending good thoughts that all goes well with the rest of her recovery.

[Guest AH2008]

Hi Wasabi303, it may be worthwhile to explore supplements with your vet in addition to the rest of your treatment regimen. There is new natural supplement out there called Boneo Canine that is based on a lactoferrin complex and is supposed to support bone health specifically. The company also has information about the science behind lactoferrin on their website that looks promising.