Logan sprained ankle

[rsieg]

So  Logan sprained his right rear ankle a week ago from last Friday, pretty sure it was when he slipped on ice.  For reference, he is 11 yr 10 mo old now, so definitely a senior. I took him to the vet on Saturday Feb 12. Vet did x-rays and saw a dislocated toe, sent them to a radiologist for a suspicious feature on one toe but fortunately came back negative for osteo (but definite arthritis). Vet bandaged his foot and sent us home with a prescription to double his Vetprofen from his usual 1 pill/day to 2 pills/day, and instructions to keep the bandage on until the next Saturday (yesterday) and call the vet with a progress report on Monday (tomorrow). Bandage stayed on till  Wednesday night when Logan took it off. I rebandaged it, he got it off Thursday night, rebandaged again and I took it off Friday night. Status is he is still not putting much weight on the foot when walking, though he can put weight on it when standing or when necessary to lift his left leg to urinate (but he was always able to do those things even after hurting it initially).

I was looking at the foot today, and noticed one paw pad has a big indentation. So now I'm wondering if some of the problem is a pad problem.

So I guess my questions are:

(1) What is that indented part of the pad? Is it possibly what is causing him to not put weight on the foot?

(2) How concerned should I be that he is still not putting weight on his foot after a bit over a week? (He has had sprains before and gone two or three days before putting weight back on it, but never this long).

(3) What should I ask the vet tomorrow, beyond giving the update report?

Thanks in advance for any information or advice!   - Rob

 

Here are some pictures of the indented pad//:

For reference, here is a comparison of the lame right rear foot and the good left rear foot:

and the foot by itself:

And one gratuitous photo from before he got hurt:

[Remolacha]

I don’t have any advice about the dent in his pad except to mention it to the vet. Also tell him the foot is still swollen and he doesn’t want to put weight on it. That said, if it is truly sprained, not just “tweaked”, it will take longer than a week to heal. Plus, with arthritis and him being a senior, that could add to the healing time. Think about how long it would take your ankle/foot to heal if you sprained it rather than just twisted it. 
I hope your handsome boy starts feeling better soon!

[greysmom]

IMO, it looks like:

1 - he either had a separate injury to that pad that's still healing, OR he's starting to get a corn

2 - (other than the pressure sore on the top of his foot)  it looks like the area to the rear, right above his main pad is still really swollen, even up to the "ankle" area (I can't see any higher on his leg in these shots).  This leads me to believe he may have injured the toe tendons more than just a strain/sprain - maybe a partial or whole tear of one or more flexor tendons.  

I would ask the vet to snap a quick shot of as much of the leg as possible, just to rule out a broken bone that wasn't visible before (some of those smaller toe bones can hide non-displaced breaks).   He probably refused the bandage because of the developing sore, and I would be cautious about rebandaging until that was taken care of, but he probably does need support on that leg for a few more weeks.  Definitely on leash walking only and restrict his activities as much as possible.

Warm epsom salt soaks of as much of the swelling as you can, a couple times a day, will help both the swelling and the sore.  Plus also, icing in between times.  And keeping him on an nsaid for a while longer.  Also a real pain medication like codeine sulfate could help keep him more comfortable.

[cleptogrey]

To me it looks like he is knuckleing . It happens with age and neurogical changes/decline.

I loosely wraped vet wrap into a short boot. I changed it every other day. Loose is the key. If done properly he won't take it off. Remember to air the paw out.

All nails need trimming, that will help with his gait. 

And do ask about the vet about alternative antinflammitories. It's finding the right one.

Keep on truckin!

Edited February 24, 2022 by cleptogrey

[rsieg]

Quick follow-up here. Vet prescribed an additional pain pill on Monday, but did not recommend bandaging the foot again. Her big concern was to keep it rested. Logan actually started putting weight on it Monday evening when I took him out to go potty, so since it seemed to be improving I held off on the additional pain pill (still getting 2 vetprofen per day). He seems to be getting better each day, now he puts full weight on it and generally walks normally on our potty walks, though he is still holding it up sometimes especially right after he gets up after sleeping for a few hours. So I am feeling pretty good about his progress, big challenges are that he now wants to go for longer walks (I have kept him down to 0.5 mile of slow leash walking at most, and even that is difficult as he is quite stubborn and wants to go further), and of course we are supposed to get another ice snow/storm tonight. Thanks for all the information!