Carpal chip fracture- Sasha needs surgery

Posted by: Natalie559

Carpal chip fracture- Sasha needs surgery - 04/07/10 11:54 AM

I got news on Sasha yesterday that she has a carpal chip fracture (right 'wrist') and will need surgery to either remove the chip(s) or pin it/them in place.

I have mixed feeling as of now. I am happy to get a diagnosis and to be able to have her fixed, but I feel bad about this having been an ongoing problem for her that we are just now getting a handle on plus her having surgery is a bit intimidating.

To sum up what's been going on- Sasha started having problems back around Thanksgiving. The PT examined her and said she had a hyperextension in her toes. We did various things for her including a lot of rest and she improved. But it would be aggravated again after times where she'd been more active, causing her to limp.

The vet examined her again and found a lump on her toe, said she had ingrown hairs from one toe rubbing the other, and so she thought the limping was from the lump hurting every time she used her foot. I used a shampoo that flushed the hair follicles and removed a lot of hair with tweezers. Since hairs came out we thought again that we had a handle on the problem- figured the hyperextension had caused her to shift her weight which caused the lump on her toe.

She improved only to start limping again so I took her in for an adjustment thinking maybe she limped and rubbed her toes b/c something was off from the hyperextension impact. They found a sublaxation in her right elbow so once again we thought we had a handle on the problem.

She improved for a few days and then became very lame after a 2 hr trail walk. We did xrays yesterday and found the problem. The vet thought that it looked relatively fresh and did not think that this had been the problem the entire time. I am not so sure and feel bad for not having done xrays sooner. So I wonder if multiple things happened here, or she just fractured months ago and has been dealing and compensating with it since frown

Here's Sasha and her injury:





The xrays have been sent out to 3 ortho vets for their opinions on the best surgical route to take. I'll update when we here from them.
Posted by: jarn

Re: Carpal chip fracture- Sasha needs surgery - 04/07/10 11:57 AM

I'm sorry Sasha is going through this. I hope whatever route you end up taking that it goes well.

I wouldn't feel guilty - you were working with the vet and taking all reasonable steps to help her.
Posted by: Bradyddr

Re: Carpal chip fracture- Sasha needs surgery - 04/07/10 12:44 PM

So sorry but at least you know what the problem is and it can be fixed!!
here is to a speedy recovery
Posted by: Barb E

Re: Carpal chip fracture- Sasha needs surgery - 04/07/10 01:24 PM

Sorry to hear about Sasha - I'll keep my fingers crossed for a smooth and least complicated surgery.
hugging
Posted by: LJsMom

Re: Carpal chip fracture- Sasha needs surgery - 04/07/10 02:05 PM

I'm sorry Natalie, but happy that you have an answer and that it's fixable. hugging
Posted by: GSDTrain

Re: Carpal chip fracture- Sasha needs surgery - 04/07/10 03:58 PM

Sorry to hear about Sasha.
Sending positive thoughts that the surgery and recovery go smooth
Posted by: Koda's Mom

Re: Carpal chip fracture- Sasha needs surgery - 04/07/10 06:09 PM

Poor Sasha girl. Koda and I send our love. I hope the ortho vets find an easy solution.
Posted by: MaxaLisa

Re: Carpal chip fracture- Sasha needs surgery - 04/07/10 08:06 PM

Aw crumb, I'm sorry it's been so difficult to get this figured out! I'm glad you guys are on the right path now, even though this stuff is never easy, nor is it fun frown
Posted by: Natalie559

Re: Carpal chip fracture- Sasha needs surgery - 04/13/10 12:47 PM

Thank you all so much for your support, I really appreciate it!

My vet consulted with the surgeons and they all thought that the fracture was cause by a carpal hyper extension injury, which I agree with. Basically there are ligaments and tendons running over the joint and if enough forced is placed in the wrong direction the tendons and ligaments chip the piece of bone off while also completely to partially shredding the tendons/ligaments at the same time, in Sasha's case they think partial as she still uses her foot and is not down in the carpal joint.

Since you have all these dynamics going on with this injury two of the surgeons said to fuse the entire joint (!) which is not a desired surgery as it is very invasive and a fused carpal is not want you want at all!

The third surgeon suggested aggressive conservative management to try and stabilize or heal the tendons/ligaments which in his opinion is where the pain comes from- not the bone chip, he thought that was high enough above the joint capsule to where it wasn't the primary problem. His opinion was that surgery to remove the chip might not fix the problem, as we would still be left with damage to the supporting structures.

So we are going to try CM and hope that it heals Sasha. She is ordering an othro vet carpal support brace that Sasha is to wear anytime she is not resting in the house, she will receive twice weekly laser therapy and will get the supplement ligaplex II. She will be on the anti inflammatory rimadyl for 3 weeks and on tramadol which they say is a safe pain reliever. We will reevaluate in 4 weeks or so.

Surgery was scary, but I thought we had a fix, so it is upsetting that we are in the trial and see phase again, once again putting more time and more money into the problem. But if a surgeon has an opinion other than surgery how can you not try it first. So we will try this and hope like heck it works! I am just so ready for my dogs to not be injured!
Posted by: MaxaLisa

Re: Carpal chip fracture- Sasha needs surgery - 04/13/10 03:05 PM

Wow, that all sucks. And you're right, when a surgeon suggests something other than surgery...I would be trying it too.

I was going to suggest Ligaplex II also. Wondering, have you tried that on Penny with the knee? I think Max would be allergic to it.

These darn dogs, they just can't give us or themselves a break!!
Posted by: Natalie559

Re: Carpal chip fracture- Sasha needs surgery - 04/14/10 10:41 AM

Thanks Lisa. No I have not tried the Ligaplex II on Penny, not sure why I never did- maybe because I was relying mostly on scar tissue vs ligament healing, but she is doing very well at this time which I am very thankful for smile .
Posted by: MaxaLisa

Re: Carpal chip fracture- Sasha needs surgery - 04/14/10 01:54 PM

I'm glad to hear that Penny is doing well! laugh
Posted by: Natalie559

Re: Carpal chip fracture- Sasha needs surgery - 04/22/10 04:46 PM

Sasha's brace came in last week. She's adapting to it better than us. I think I'll need to continue with the vet wrap to keep it from slipping.

She is actually limping a bit more now after having worn it for several days. I think it is from sore muscles in her shoulder as she is adapting to a new gait from not being able to bend her carpal joint at all. Of course I worry that it's because maybe the straps are rubbing the fracture. I will ask the vet about this when we see her for the next laser therapy.

She does get relieved of the device while sleeping at home to keep a range of motion within the join and to air out the leg.





Posted by: MaxaLisa

Re: Carpal chip fracture- Sasha needs surgery - 04/22/10 06:00 PM

Oh wow, Sasha's a trooper!! How long is she going to have to wear it?
Posted by: Wisc.Tiger_Val

Re: Carpal chip fracture- Sasha needs surgery - 04/22/10 09:59 PM

I agree Sasha is a trooper. But then again dogs are pretty darn adaptable and resilient.

Val
Posted by: Natalie559

Re: Carpal chip fracture- Sasha needs surgery - 04/23/10 10:53 AM

Thanks.

Originally Posted By: MaxaLisa
How long is she going to have to wear it?


6-8 weeks- We are hoping for some healing, but ultimately scar tissue will play a role and it takes 6-8 weeks to lay down. Sounds familiar, huh smile

Originally Posted By: Wisc.Tiger_Val
dogs are pretty darn adaptable and resilient.


They really are, it's amazing and that's why I said it has been harder on us than her. She just goes along with it. But she also has a great personality, lets me do whatever I need to to her so I am sure that helps.
Posted by: MaxaLisa

Re: Carpal chip fracture- Sasha needs surgery - 08/05/10 02:31 AM

How is Sasha doing?
Posted by: Natalie559

Re: Carpal chip fracture- Sasha needs surgery - 08/05/10 10:26 AM

Wow times really flies doesn't it?!

Sasha wore the hard brace pictured for 8 weeks. She did very well with it. Then we transitioned her into a carpal flex soft brace with supports:



It comes with 3 support straps that velcro onto the soft outside material. She is to wear it for 8 weeks and to slowly take the support pieces off. I have taken off all 3 and she has about 1 week left to wear it. She's been swimming since in the soft brace.

So far so good, no limping or other signs of injury. So I hope this has done the trick but it will be hard to know for sure until she is able to repeat the more heavy exercise that would previously cause her to limp. She may end up needing the brace for heavy exercise but that would be okay.
Posted by: Lexi

Re: Carpal chip fracture- Sasha needs surgery - 08/05/10 10:28 AM

Oh wow, she's just beautiful!!!! I love her eyes and her coloring. Seriously, I could get lost in those sweet eyes. wub

Just now read the thread and I'm glad she's doing so well. Keep up the good work, Sasha!
Posted by: Wisc.Tiger_Val

Re: Carpal chip fracture- Sasha needs surgery - 08/05/10 10:51 AM

She does look happier with the soft brace. What a pretty girl. I am glad things are working well so far.
Posted by: MaxaLisa

Re: Carpal chip fracture- Sasha needs surgery - 08/06/10 01:26 AM

She looks very happy and content there smile

I'm glad to hear that things are progressing well. I was searching for something, and ran across her thread. Thanks for updating!
Posted by: MaxaLisa

Re: Carpal chip fracture- Sasha needs surgery - 11/12/11 07:57 PM

Natalie, are you around?

Just wanted to check in and see what you thought of Sasha's brace. Jean and I are looking at them now: http://germanshepherdhome.net/forum/ubbthreads.php/topics/193218/Re_Mila_Grand_Old_Dame#Post193218
Posted by: Natalie559

Re: Carpal chip fracture- Sasha needs surgery - 11/14/11 11:41 AM

I read a little of the thread- loose ligaments. Are they wanting scar tissue to stabilize the joint, or to just use something for support?

We wanted to enable scar tissue to form, the joint needs to be somewhat stable to do this so we started with a OrthoVet Carpal Splint

http://www.orthovet.com/storefront.html?...13&vmcchk=1

Then after 6 weeks or so we switched to the thera-paw Carpo-Flex X

http://www.therapaw.com/carpo-flex-x-2.aspx

Both of the braces worked very well for what we needed. My vet measured Sasha and sent off for a custom fit one, but neither was that expensive.

What I liked about the carpo-flex x brace is that it comes with 3 sturdier velco support 'patches'. You can cross them, remove them or just use 1 or 2- makes the brace customizable for the dog and situation.

Sasha still wears this brace when we hike in the woods as she will always have the bone chip that can cause her discomfort after long periods of being active- so I use the brace to minimize the moving of the chip.

If she become sore the vet has me rub her joint with dmso gel (wear gloves) to bring down the inflammation.

I give both of the braces a big thumbs up! thumbup

Hope that helps smile
Posted by: Qyn

Re: Carpal chip fracture- Sasha needs surgery - 11/15/11 06:18 AM

Natalie, sorry I missed this when it was first an issue with your gorgeous girl. I am so glad to read that it has helped to the extent that she is able to continue her hiking, plus that she has avoided the surgery which may have reduced or even stopped that activity. thumbup
Posted by: MaxaLisa

Re: Carpal chip fracture- Sasha needs surgery - 11/15/11 12:37 PM

Rhanks Natalie, that helps a lot! I asked more about sizing in Mila's thread.

I'm so glad that Sasha is doing so well, and Penny too!
Posted by: Natalie559

Re: Carpal chip fracture- Sasha needs surgery - 11/17/11 08:56 AM

Thanks Alison and Lisa!

And Lisa, yes the carpo brace was custom measured for Sasha- only took the vet a few minutes.
Posted by: MaxaLisa

Re: Carpal chip fracture- Sasha needs surgery - 11/17/11 03:30 PM

Thanks Natalie, good to know!