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Pet Prosthetics and Braces Questions and Answers, Part 2

There’s lots to consider before putting pet prosthetics and braces on dogs and cats. In today’s second webinar about leg braces and supports for amputee pets, Drs. Sherman and Debra Canapp answer questions sent from viewers who watched the pet prosthetics and braces webinar for vets and pet parents, “Tripawds & Prosthetics: How to care for our 3-legged friends.” Be sure to watch if you haven’t already, and learn all about amputation surgery, prosthetics as an alternative to full limb amputation, prosthesis types, rehabilitation, common complications and more!

pet prosthetics and braces
Get your pet prosthetics and braces questions answered here! (Image: Dive Design Co.)

Keep reading for answers to viewer submitted pet prosthetics questions. Originally aired in November 2020, the webinars were presented by Drs. Canapp, founders of Veterinary Orthopedic Sports Medicine Group and Canapp Sports Medicine. Together, they worked with Tripawds to create a RACE-approved pet prosthetics webinar and questions-and-answers session for vets and pet parents. And it was made possible by the talented pet prosthetics creators at Dive Design, makers of high-tech support braces and prosthetics for Bionic Pets.

Watch the video below, download the podcast, or read the full transcript at the bottom. Got more questions about prosthetics? Post them in Tripawds Hopping Around Discussion Forum topic!

Tripawds Pet Prosthetics and Braces Questions and Answers, Table of Contents

[0:06:54] Do Tripawds need braces? If so, what kind of brace material is best?

[0:09:06] What are a pros and cons of a forelimb amputee brace?

[0:10:14] Should a Tripawd wear a front leg brace? If so, when?

[0:11:30] How do you break-in a front leg brace for dogs?

[0:12:21] Where to get a front-leg amputee brace (and when to use it)?

[0:13:07] Can a brace stop a Tripawd’s leg from bowing out?

[0:13:47] What are front-leg Tripawd compensation issues?

[0:15:01] Can rehab and exercises prevent the need for a leg brace?

[0:16:17] What about joint stress in forelimb amputee dogs and cats?

[0:18:00] What’s the best way to protect joints on a front-leg amputee dog?

[0:19:48] Can front-leg amputee cats missing a scapula wear prosthetics?

[0:24:11] Can older dogs wear prosthetics? Will it help improve quality of life?

[0:27:58] Do you need a rehab therapist before getting a dog prosthetic?

[0:29:45] Is a suction suspension prosthetic or a harness prosthetic better for front-leg amputee dogs?

[0:39:00] What are the best joint supplements for Tripawd dogs and cats?

[0:46:17] Does dog breed influence prosthetic success?

[0:48:38] What kind of surgeon is best for pet prosthetics?

[0:50:53] What about joint fusion surgery for a rear-leg Tripawd with arthritis?

[0:59:14] What are common hind limb Tripawd joint problems?

[1:00:24] Can a prosthesis help a Tripawd dog or a cat live longer?

LEARN MORE! SEE PART ONE:
Tripawds’ Guide to Pet Prosthetics for Vets and Parents

Listen to the Tripawd Talk Radio Audio Broadcast Episode

Audio Transcription: Pet Prosthetics and Braces Q&A with Canapp Sports Medicine

TRIPAWDS: Hello again. This is Tripawd Talk Radio. And for this episode, we are sharing the full live Q&A from our webinar with Dr. Sherman and Debra Canapp of Veterinary Orthopedic & Sports Medicine Group, recorded in November 2020.

Listen to Part 1 of Tripawds and Prosthetics: How to Care for our 3-legged Friends for complete details all about amputation surgery, the use of prosthetics as an alternative to full limb amputation, prostheses types, rehabilitation, common complications, and more.

(The following is an abridged transcription of our helpful pet prosthetics and braces discussion with Drs. Sherman and Debra Canapp)

[0:06:54] Do Tripawds need braces? If so, what kind of brace material is best?

DR. SHERMAN CANAPP: If you think about the forelimb amputations, and when I see a Great Dane, a Rottweiler, a large Golden Retriever, I see these – or at least one of those coming in and we know we are dealing with a 3-legged situation and a forelimb, I sit down and I say, “Ugh! What do we do to protect the body?” Because it’s the whole, it’s a chain, and if there’s something off with one portion of the chain or you’re missing that portion of the chain, the entire body, just the biomechanics are thrown off.

We know then that they’re loading that carpus or that wrist and we know within just a short period of time, all those soft tissues are going to start to, we call it creep, will stretch out and just start to become more lax. And anything we can do to protect those tissues is going to be hugely beneficial.

Now, there’s a fine line between overprotecting them, if you put something too rigid on there, all of a sudden, the body says, “Whoa! I don’t even have to function my flexors.” Now, these support structures really have to take any load so they will actually start to atrophy and becoming a little bit more dysfunctional. So it’s a fine balancing act between keeping that carpus at a normal standing angle and protecting it and keeping it comfortable but not overprotecting it.

[0:09:06] What are pros and cons of a forelimb amputee brace?

The first thing I like to think about when we are dealing with a forelimb amputation and we are looking at even a smaller breed, definitely with the large or giant breeds, is how are we going to support and protect that absolutely is the obvious one. I’m not a consultant for Thera-Paw but it is a company that we use commonly. Full disclosure, we do like their products. There are many others out there, DogLeggs has some, OrthoPets has them. There are so many but I like the neoprene simply because they give a little bit more – a little bit of flexions so we are not fully loading.

If a larger breed dog, we can add extra straps to give it a little bit more support. We can put a thermoplast, a molded classic type material in there to give even further support, and they are easy to clean. They’re neoprene so you can take them off, clean them, and put them on.

Usually, I recommend that an owner gets a couple of them because periodically, how do you end up in the lake, how do you end up in the beach, and things happen, it’s raining out? And if it’s moist, they’ll get a dermatitis so they want to take that one off, go clean it, put the new one on. But I’m a huge, huge fan of protecting the carpus. What are your thoughts?

[0:10:14] Should a Tripawd wear a front leg brace? If so, when?

DR. DEBRA CANAPP: I think definitely but I usually use them mostly for activity, right? And so, in order to make sure they don’t become dependent. If you are taking a normal tripawd in the front end, that has a normal carpus on the other side, yes, we want to protect it but we don’t want to overprotect just like Sherman said. We want to make sure that maybe if we are going to go hiking for 3 hours, they wear it. But then when around the house, if they go out to go potty, they don’t need to wear it.

That would change if the dog already has them, carpal hyperextension or starting to break down or has arthritis. Well then, we would have that on more of the time for more support. And then again, I think it’s also gauged in.

If you have a normal dog, you would never want to put them in a thermoplast or a rigid splint because you would take away all of that support that’s already there. But if you have a dog that has to go for a forelimb amputation and has already broken down the other side, there are so many things we can do to help them out.

It’s really important to just make sure we remember that God kind of gave us all the joints for a reason. So if you take a joint away, it affects all the other joints above it. Even though we are trying to do the best we want to do for the one joint, we actually hinder the other ones. If we can keep it as natural as possible for that same support when we are going to doing our zoomies and going crazy then that’s kind of our goal.

[0:11:30] How do you break-in a front leg brace for dogs?

DR. SHERMAN CANAPP: Yeah, and breaking through is really important. One of the biggest complications we see with any device, any wrap, any support prosthesis, we will talk about this when we talk about the prosthetics for the forelimb or the hindlimb is soft tissue injury. So definitely slow break-in period but client education, the owners have to be aware that, “Hey, I haven’t put this on for a few hours and I’m going to make sure it didn’t shift, that there’s no rubbing. OK, we went for a hike, the first thing I do when I get back is I’m going to take it off, make sure there are no sores or rubbing or irritation.”

It’s almost like if you get a brand new pair of Nikes and now you’re going to go up for a hike and you haven’t really broke them in yet and you get a blister but you know it’s there. You took your shoes off in site. But if this dog is living in its orthotic, the owner didn’t see it, boy’s that’s going to get worse and worse and worse. So I think a slow, gradual break-in period to them and just make sure that you’re looking at the soft tissues, make you don’t see any rubbing or irritation.

[0:12:21] Where to get a front-leg amputee brace (and when to use it)?

DR. DEBRA CANAPP: I think they should really have a conversation with their veterinarian and just probably see, again, if you have a younger dog that had to have an amputation for some reason then probably not and kind of watch them over time.

There are some that you can get over-the-counter that might be just good enough for them when they go out for their long hike or for when they run out in the yard. But then the other ones that maybe already have a problem or we suspected they’re going to start breaking down just because of maybe creep then I would kind of work with your rehab veterinarian to get one prescribed, maybe more of a custom one instead of one just right off-the-shelf.

front leg amputee dog Moose
Front-leg amputee dog Moose stands tall and proud!

[0:13:07] Can a brace stop a Tripawd’s leg from bowing out?

DR. DEBRA CANAPP: If we are talking about bowing because of like a collateral ligament kind of strain or kind of breakdown, yes. I laugh, I giggle a little bit because some dogs have angular limb deformities and they can bow naturally. You can’t fix that with a wrap. But some people try and it doesn’t work out very well. So if it’s just soft tissue, absolutely. You can definitely support or you can put some bands on the outside to give even a little bit more support or we can help that from breaking down. But if it’s just bone change, then no.

[0:13:47] What are front-leg Tripawd compensation issues?

DR. SHERMAN CANAPP: . . . If you think about doing a handstand or even a push-up, what happens? The closer you get your hands together, it’s more challenging. But you bring your hands out, you have a little bit more support and balance. So we just took that limb away, instead of being where it should be mechanically, all of a sudden now, they are trying to do this and then what they’re doing is kind of – you’re watching their body kind of turning, you’re starting to see a little bit of curvature to the entire core of the spine. And what’s going to happen then is biomechanically, the shoulder or rotator cuff was supposed to be here. Now, all of a sudden, they are balancing like this.

You will start to see some tendinosis, tendinopathy, strains to the soft tissues up in the shoulder, and that’s why later on we will touch once again about body works, seeing a periodic massage therapist, rehab therapist, someone that’s going to really look at the whole dog and just from a maintenance standpoint because all these tissues are going to start to get a little angry over time just from the way we now have to compensate. But that’s exactly – it’s a great point because that leg is going to come out, it meant to go here, we are support the wrist but that leg still may go out, at least we are protecting the wrist, but now we have the rest of the chain we also have to maintain.

[0:15:01] Can rehab and exercises prevent the need for a leg brace?

DR. DEBRA CANAPP: I mean there are so many different types and it’s so hard to blanket it because every patient is so individual. But just kind of targeting if again, if we are talking about forelimb, if we are just – if you have a little bit of atrophy in one muscle or the other, there’s definitely types of exercise we can target like sitting to a down, to sit, to stand. It’s kind of push-ups for dogs.

A lot of times with our tripawds, we try to do kind of swim assist or underwater treadmill assist so that way, swimming is a little bit difficult because they only have the three legs. But you can definitely help them with a life vest and help them swim without that weight-bearing type of impact on those joints. So there is definitely different exercises, different types but it all benefits and we can definitely where things are.

[0:16:17] What about joint stress in forelimb amputee dogs and cats?

DR. SHERMAN CANAPP: I want you to do a handstand just on one hand and you’re going to sit there and you’re slowly going to start to kind of get weaker and weaker and weaker and all your soft tissues. In a dog’s wrist that we are still talking about the forelimb. They have flexor tendons, they have what’s called accessory carpal ligament which goes up. It has another very large tendon. And then from there, there are all these ligaments that come down. There are many.

And then there is – we call it these collagen support structures, all in between the pads and the foot if you would. We call this the palmar surface but basically, underneath. All those work together think of like a shock absorber. It’s going to keep the dog up on his toes. Now, certain dogs are really up on their toes like Dobermann, German Shepherds. They already have a little bit more hyperextension, usually about 16 degrees, 12 to about 16 or 18 degrees, depending on which type of German Shepherd.

But regardless, as that dog is loading, putting all that weight on that wrist, it’s going to continue to create and slowly breakdown not just these structures over here, your collateral ligaments, all these start to just kind of become strained or sprained. Eventually, it could get to the point where they are completely dropped. And then what happens is when you’re starting to immobilize the joint, remember this is a joint, the wrist is a joint, so we are talking about the soft tissues, but you’ll get arthritis in that joint. So your toes will start getting arthritis, all the little bones and joint spaces within your wrist area will get arthritis as well.

[0:18:00] What’s the best way to protect joints on a front-leg amputee dog?

So we will talk a bit later about supplements and things you can do to help your joint, but we also have to try to protect the soft tissues just from, I call it, stretching out if you would, but it’s really breaking down from just the weight. It’s supposed to be most dogs are 60-40. OK. So 60% of the dog’s weight is upfront, 40% is in the back because the chest, most of the muscle and so forth and chest cavity is upfront. That means it’s 30-30. OK, 30-30 for 60%, 20-20 for 40. All of a sudden, this 30 had to go somewhere. Well, it’s going partially to here and then partially back.

We also have to worry about not only the other front limb, the opposite hindlimb. OK? So all of a sudden, the lower spine, the hip, the knee, all those things start to take on kind of a toll as well from compensation. We are trying to kind of protect the soft tissues and we want to start thinking about it sooner than later. I I’m doing an amputation, I’m having the chat already with the owner about, “Hey, we need to think of the limb we are leaving behind. What are we going to do to maintain that, support, and protect it?”

[0:19:48] Can front-leg amputee cats missing a scapula wear prosthetics?

DR. SHERMAN CANAPP: . . . . Cats are tricky. We are so limited . . .Could we use these devices for cats? Absolutely. And I think there are some questions later on even more about cats, but that’s where the endoprostheses works quite well. Also, because if we try to even put a bandage on a cat, by the time it’s in the parking lot out of the vet’s office, it’s falling off and the owner brings it back in and says, “You may need this.” So it’s hard to keep anything on a cat. What we found was that if you use a prosthetic that actually goes into the body itself, usually they are cemented or pressed in, those have the better outcome for cat than trying to strap something on because you put it this way and all of a sudden it’s this way on the cat.

[0:24:11] Can older dogs wear prosthetics? Will it help improve quality of life?

DR. DEBRA CANAPP: Right. Yeah. I think it’s important – again, it’s so individual, right? And so, the thing is, if there is an articulating joint that is left, if they’re still using a leg like there was the rest of the leg there, then I think they would be a perfect candidate for it. And so, the way we approach any dog with any injury is we never would think no. We always like think beyond the stars and be like, “They’re going to get back to doing everything they ever wanted to do,” and then allow the dog to tell us.

Yes, with a prosthetic, you may have to invest some money and ends up with a dog that says, “Hell no!” But I would say 9 times out of 10, you can really as long as you take a slow, gradual process in introducing them and have lots of positive reinforcement. And not every dog will use it. So it just really kind of important to know the dog exactly what limb, is it full or partial, and then how is that dog actually using themselves. And that may really, really help. I mean she maybe a couple of years ago may have said no to the prosthetic but now that she is getting older, well, that’s a little bit of support, may accept it even more now. So I think it’s really – I still think it’s possible.

Pet prosthetics cost and time considerations

DR. SHERMAN CANAPP: There’s no reason not to try it. But they’re not inexpensive. So for an owner, you made the comment about cost. I mean there is some cost. I went to a lot of this on the video. I kind of went through the step-by-step fabrication process and we looked DiveDesign as well, which is 3D modeling and 3D printing. I mean it’s crazy Star Wars. But it’s a lot of work and manpower for these guys to make these devices and the materials they are using are high tech and extremely expensive as well. So that’s why they cost what they do.

When I say to an owner that has had their dog or companion that has been out for a bit of time, I say, “Listen, there’s nothing wrong with trying. But you’re about to spend a certain amount of pennies to get the device. It’s going to take some break-in. It’s going to take some introduction. You’re not just going to put it on and go hiking, a lot of work to just even get the pet to accept it, to even think about it.” And as long as you are willing to put in the man hours and put in the resources, why not? Why not?

But they have to realize there are going to be some situations where even for the acute ones, even for ones where we just did the surgery and we had everything timed and prepped and the owner is on board and they can afford it, and we put it on the limb and we are doing the rehab and the dog is like, “I’ll just carry it.”

And they are like, “This is so fun.” So you just never know. You don’t know. And so, you try. You try. But everyone has to go in with an open mind saying, “We’re going to give this a go.” It’s a team approach. And many times like Deb said, it’s successful but you’re going to have those that it just did not work. It just did not work.

[0:27:58] Do you need a rehab therapist before getting a dog prosthetic?

DR. DEBRA CANAPP: I think there’s a lot of value in that, because I think there maybe some cases that it’s kind of obvious that you’re going to probably invest in something that’s not going to work. So I think that would be a valuable first step just to know if it is a good possibility. We still can’t predict but I can at least tell you, hey, in my experience, I don’t think this dog will use one. But in my experience, this one most likely will. So I think that’s important.

[0:29:45] Is a suction suspension prosthetic or a harness prosthetic better for front-leg amputee dogs?

DR. SHERMAN CANAPP: It really depends. When we look at a patient, I look at the breed, I look at their biomechanics, the angulation of their limbs, where they were missing that portion of the limb or where we have to. Yeah. And so luckily, if you hurt below the elbow, we have a lot more wiggle room of working on these different types.

Suction suspension prosthetic

Jeff Collins who is up in Nova Scotia, Canada, (is) a phenomenal guy, incredible person when it comes to all these types of devices. And we actually published a paper with him for knee braces for dogs that tore their CCL or ACL. We had the first publication on that. And he was instrumental early on with us as well just like Derrick in understanding these. And he was the one that introduced us to the suction.

And essentially, you have like a Surgi-Sox that goes on and you have another little wrap that goes on and then the device itself actually slides up and forms like a suction if you would to that location. So it doesn’t shift. It doesn’t require all the extra straps and the harnesses and things and they do quite well with that. He has more of – the bottom of it is more like instead of – Derrick says, it has like a rocker bottom where there is little foot. This is a more rounded bottom so it’s a little bit different biomechanics. Yeah.

The best prosthetic style is different for everyone

And honestly, they both work well, both of them. We work with so many of these great companies and these guys are incredible what they manufacture. And so, the suction, many times that we tried one and if we are like, “This one is turning or slipping,” and we can’t modify it well enough to get it to work for that patient, we may go from one that’s a harness or straps to the suction.

Again, we go into the owner and say, especially for situation like yours where it non-cancer. This is long-term. You know what? You may not like Reebok like Nikes or you might like Brooks. I mean there are so many different ones that you may – like as far as you’re running shoes and you’re going to try different ones and some work and some don’t, same with these, these prosthetics and you say, “Oh! Well, it’s really expensive.” But this is over the course of your dog’s life especially if we are looking at long term and the situation where it’s not a cancer type of event that brought us to this in the first place.

[0:39:00] What are the best joint supplements for Tripawd dogs and cats?

DR. SHERMAN CANAPP: The Dasuquin product, that’s Ferrari of supplements, the Dasuquin with MSM, your omega-3s, the Dasuquin Advanced, 1TDC which is another great anti-inflammatory holistic for the joints, MYOS, what you probably saw on the webinar to keep their muscle mass up and support it. Then in the joint, if you and I had arthritis, say it’s our knee which is similar to their elbow, then we have these knee pains but their elbows get arthritis similar to what our knees will get, injections into the joint are something that could be very beneficial as well.

If you think about it, people get injections on their knees all the time. Horses do as well. And there’s quite a bit of holistic kind of conservative things you can inject into that elbow if it’s periodically having some flares or some issues, everything from hyaluronic acid which is a joint lubricant, platelet-rich plasma which is just a blood sample, spin it down, inject, and it’s anti-inflammatory, all the way up to things like stem cells.

Balancing supplements and pain medications

There are quite a bit of things that would help to just kind of maintain that elbow because we want to keep that elbow as happy as we can. Elbow dysplasia is horrible for dogs. It’s the most common cause of lameness in dogs worldwide. It’s a challenge. We don’t have elbow replacements so we have to medically manage these. Scooping was the right thing to do initially as well.

You’re doing the right things there but we would definitely think about a lighter wrap maybe for the wrist and if the elbow is periodically flaring or acting up, think of your local rehab vet specialist or surgeons that deal with sports medicine to maybe do some injections into the elbow to calm it down.

DR. DEBRA CANAPP: . . . I also believe in holistic type of medicine where I really want to try my supplements because I don’t like the nonsteroidals. I don’t like using them just frivolously. I like to use them when needed. I don’t – but I like to really support the dog so I have to – I don’t have to give that until like very isolated incidents.

Three joint supplement recommendations for active amputee dogs

But you are starting exactly what I would recommend. So the Dasuquin, I like Dasuquin Advanced because I like the turmeric and the boswellia, the additions there, to help with the anti-inflammatory properties in the joints. I use Dasuquin Advanced and then the Welactin or the omega-3. So I use those two plus the addition of 1TDC as my three bases of joint supplements for dogs that are very, very active or they’re tripawds or dogs that have had an injury. And then I add on to that.

I do really like MYOS. My dog is on it because she has really bad shoulders. And so, it’s hard to keep up her muscle mass well. So for a tripawds, again, depending on how they are getting along, MYOS is wonderful because it really keeps that support for the joints.

. . . .But I also have gradually added on to my daily routine with my dog as I saw the knee for her is kind of extended. So again, I started off with my three supplements when she was a year old. And then I’ve kind of added in the MYOS. I’ve actually added in some green-lipped mussel supplements. I’ve added in CBD oil which I can’t talk about but yes, on my own pet. But yeah, so as she needs some more and more, I kind of added them on throughout the years. But I think you have a great basis. I would add the 1TDC because I like that combination. I think we grab it from all different kind of approaches to make a really nice basis.

[0:46:17] Does dog breed influence prosthetic success?

DR. DEBRA CANAPP: I think that actually the personality of the dog actually probably weighs a bit more in than the breed mechanics because again, they have to be open to this external like foreign piece to become incorporated into their body. And so, I think the approach and the gradual introduction period is like a really big important part of it. But I do think with a very talented prosthetist, they can make anything work honestly. I mean I’ve seen Bulldogs, like English Bulldogs with prosthetics and I’m like, “Are you kidding me?” And then I see like a Lab refused to use it. So it’s something that I’m always open.

DR. SHERMAN CANAPP: Yeah. I would talk to the prosthetist first also and get their experience and thoughts. And what I tend to find is the smaller and squishier and more, we call it brachiocephalic, turn in, turn out angle limb deformity kind of a bit more challenging than your Lab, in your Great Dane, it could be a Dobermann, it could be the English Bulldog and then as we shrink down to the Bulldogs, they are more challenging. The Corgis are starting to become more challenging, the Dachshund becomes really – so can it be done? Absolutely.

But we also go into it with the owner – with them realizing, listen, this could be a little bit more challenging. We are going to give it a go. I always also like to reach out to the person creating your device in advanced. Take pictures, videos. Hey, here’s what we have coming up your way, let me help you to help us.

[0:48:38] What kind of surgeon is best for pet prosthetics?

DR. DEBRA CANAPP: . . . I think it’s really important to talk with your surgeon and to know their experience because, Sherman has done a lot of amputation and he knows not to put the incision on the bottom part of the left of their limb. So that way, when they go into their device, that incision is on the inside so it’s not going to rub.

Again, should there be a mistake, if someone is naïve or not knowing or not having a lot of experience in amputations, but the people that do will make a world of difference because they will have such a better time with adding enough prosthetic.

The incision flap: critical for prosthetic success

DR. SHERMAN CANAPP: It was interesting. In the webinar, you saw Ebony. So Ebony was the dog, the older Labrador Retriever had a huge mass on the distal extremity around the wrist carpus and that was one of my first cases. I was like scared the bejesus out of me. I got to get margins. I have to – this dog had orthopedic issues I’m aware, some elbow arthritis. I’ve got to help this dog to the best of my ability. And if you look, I made a mention of this in the webinar, my incision was horrible. It was right over the end of the stump. And luckily, it didn’t break down. It didn’t drain. It didn’t get infected. But it was a novice mistake early on. Luckily, it turned out OK.

But reading as many papers as I can in the human literature and what they do with humans, you have to do a different flap. You have to do a different sort of approach to protect that stump to the best of your ability and also protect it from swelling because you got to get this thing casted and the device on, in my mind, as quickly as possible. If there’s a lot of swelling, drainage, or infection or it’s opening up, that just keeps setting you back.

I think surgical planning is important. If it’s a surgeon that hasn’t done before, have him reach out to somebody that has. We do telemedicine. We train surgeons around the world and we are in the OR with them virtually while they are doing their procedures . . .

[0:50:53] What about joint fusion surgery for a rear-leg Tripawd with arthritis?

DR. SHERMAN CANAPP: Just say no.

DR. DEBRA CANAPP: Just say no. Do everything you possibly can to avoid it. I mean there is a place for arthrodesis but I think we’ve done maybe like count on one, maybe one and a half hands, because we really tried to avoid it.

DR. SHERMAN CANAPP: Line up 10 surgeons giving a 10 different answers but I tend to be very conservative and holistic and think outside the box. You can always do surgery but you can’t undo surgery. And whether you’re fusing a wrist or fusing an ankle or a carpus or tarsus, they are plagued with complications.

Complications of joint fusion surgery include:

  • You are mobilizing this limb. You don’t have a whole lot of soft tissue here, your wrist or your ankle so it rubs on the soft tissues. They can break them down.
  • The screws can fall out. They can get infected.
  • It’s cold-sensitivity. You’re out in the snow or in the cold, you have no soft tissues here when they are walking and the metal very quickly gets cold. They can break.

I had one where I did a carpal fusion. The dog was in a cabin with his owner up in Vermont. There was a bear. The dog tried to get the bear. The plate broke in half. Things can happen. There are so many great orthopedic devices now. These support wraps and hinged wraps and braces and things that if it was my own dog, I would try 19 different ones of those before I would ever throw a plate in my dog’s ankle or wrist. I just would not do them anymore. I have seen so many complications, and not necessarily my complications. I never say, “Oh, I’m a carpal surgeon.” I see – we all have – I’ve had mine.

When you do this also, again, you’re putting metal and they swell, so they need to be ready to have leeches available because if you have too much swelling in the wrist like a tourniquet, all of a sudden, you can lose toes, you can have skin slough.

Joint fusions: just say No

The bottom line is, I’m not a big fan. Now, the surgeon she is probably chatting with is a probably a huge fan maybe because they have done it a million of these. I just would rather go with an orthotic, perhaps some sort of device that gives some support but doesn’t fully lock out the wrist or the ankle. Because it’s like a spinal fusion, you fuse here, we have domino effect. All of a sudden, you have an issue here. You fuse here, domino effect. The same with fusions in the back, spinal surgeons are so quick to fuse on the human side where you could have it just as good outcome with PT. I would rather this person, and thank you for being a VOSM patient, I would rather you try a bunch of different support wraps before you think about fusion.

[0:59:14] What are common hind limb Tripawd joint problems?

DR. SHERMAN CANAPP: The hindlimb, just to bring that point up that I’m glad you did, the forelimb, we worry about the wrist and the elbow and the rotator cuff. The opposite side, the hindlimb, we worry about that knee. The most common cause of forelimb lameness in dogs is elbow arthritis. Most common cause of hindlimb lameness in dogs is a tear in their CCL or their ACL.

And so, we are dealing with a case right now, the owner is from Vermont, incredible, incredible owners. Actually, they have a house here and a house in Vermont. And Maggie is missing a hindlimb from trauma is a Golden Retriever and she is placing all this weight on the opposite side. She is getting lower lumbar issues from kind of trying to curb when she is walking but her knee is getting more and more arthritic and breaking down.

We’ve actually placed her in a knee brace. So we are trying to protect that knee because again, trying to do knee surgery, ACL surgery on a 3-legged dog, we are trying to avoid if we can so we are maintaining with rehab, injections, knee brace. But yeah, so that’s the thing we are talking about the opposite leg that we need a prosthesis for but remember that other – the other knee. We got to protect that.

[1:00:24] Can a prosthesis help a Tripawd dog or a cat live longer?

DR. DEBRA CANAPP: I do think that prosthetics will help them be more balanced. Then with being more balanced, there is less inflammation. With less inflammation, you’re more healthy. And so yes, I do think you can do that. That is the best route to go. But sometimes situations don’t allow that and you can just do the best that you can. But any time that we can get them using all four limbs simultaneously, if it’s a prosthetic and three others ones or not, that’s the best approach.

DR. SHERMAN CANAPP: Yeah. I think it’s all about body awareness and body health. And while we may not say, “Oh, we are going to gain two or three more years,” we are going to have two or three more functional years. . . .

I think like Deb said, we may not get them the three more years because of the fact that we put this on but those three more years that they have are going to be way hopefully more functional and comfortable.

[End of transcript]

LEARN MORE! SEE PART ONE:
Tripawds’ Guide to Pet Prosthetics for Vets and Parents

Get a Veterinary Orthopedic and Prosthetics Video Consultation with Canapp Sports Medicine

If you are thinking about a prosthetic for your Tripawd, please don’t do anything until you meet with an orthopedic veterinarian with experience in pet prosthetics. Better yet, talk to Drs. Canapp yourself! This dynamic duo offer remote consultation to pet parents on issues related to musculoskeletal injuries, lameness, undiagnosed orthopedic conditions, performance related issues, early identification and prevention. Learn more at Canapp Sports Medicine.

pet prosthetic consultation
Book an online pet prosthetic consultation with Canapp Sports Medicine.

About Debra Canapp, DVM, CCRT, DACVSMR

Dr. Debra Canapp is your go-to doc for canine sports-related injury, sport rehabilitation and performance. Her formal bio is here, but in short, she’s a gifted veterinarian who is also certified in canine rehabilitation, traditional Chinese veterinary medicine and acupuncture, stem cell therapy and ultrasound-guided regenerative medicine injections. She also lectures vets on the subjects of orthopedic injuries in the sporting/working dog and the current rehabilitation techniques used to treat them.

Meet Dr. Sherman Canapp, DVM, MS, CCRT, DACVS, DACVSMR

Dr. Sherman Canapp has a mighty impressive background in his chosen field, which you can read about here. To sum it up, Dr. Canapp is the co-founder of the Veterinary Orthopedic & Sports Medicine Group (VOSM) in Annapolis Junction, MD. Dr. Canapp routinely receives referrals for sports related injuries, arthroscopic procedures and regenerative medicine treatments from domestic and international sources. Dr. Canapp’s primary caseload is performance, sporting and working dogs.

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