Re: Carpal valgus 1 year old staffie

Rebecca MacMillan — Thu, 09 May 2013 10:12:16 GMT

Thanks for your replies

I advised the owner that it was probably worth xraying the dogs forelimbs so that we could either get a second opinion or just to have the radiographs available for ourselves so we can see what is 'normal' for this dog should he deteriorate in the future. The dog was coming in for castration soon anyway, so said that would be a good time to do some xrays too. Unfortunately it appears the dog has been in on my day off and just went for the castration (no rads).

So I think we'll just have to see how this one plays out for now!

Re: Carpal valgus 1 year old staffie

John Flynn — Sun, 05 May 2013 10:13:08 GMT

Hi Rebecca,

I think it very much depends on how disabling the angular limb deformity is. I had a 5 year old, lean, Labrador in for a booster yesterday with a horrendous-looking lateral rotation of paw and valgal deformity and he runs for 5km a day without lameness. Had I seen this individual case at a year old I would have recommended exploring corrective osteotomy as I would not have expected to do so well.

As you have no crystal ball, it is very difficult to predict whether a patient that currently has no lameness or reluctance to exercise will be affected later on and, if so, whether having done a corrective osteotomy at this stage would have solved things. Sometimes it's elbow osteoarthritis that affects them later due to short ulna syndrome rather than the actual visual angular deformity more distally.

I think I would discuss with the owner about whether she wants to potentially put a dog with no lameness or reluctance to exercise through a procedure that at the very least will require exercise restriction for 2 to 3 months and always has the potential to go wrong. If the answer is no, then probably not much point proceeding (unless thinking that short ulna syndrome has caused the deformity and that proximal ulna osteotomy might perhaps still be considered to alleviate impingement of the anconeal process on the humerus, but I'm not convinced this would be the case at this age, irrespective of any radiographs, unless there was clinical elbow pain).

By all means do some radiographs to get an idea of the deformity present, but if the owner's interested in exploring options for angular limb deformity correction, then simply sending a good photo and video to a specialist might be good enough - if planning a CORA procedure, they're going to want to do their own radiographs (or even CT scan) I'd suspect. As clearly won't have any pet insurance to pick up the bill, the client would have to have pretty deep pockets to pay for this all I'd suspect, especially if both limbs, and I'd try not to eat into any resources with radiographs myself unless this was going to change the decision-making process.

Should they not wish to explore corrective osteotomies, I'd advise that such a procedure may be riskier if left another couple of years and then required and that keeping the dog to a lean body weight and giving NSAIDs in the face of any discomfort at a later date might be a good option. If live near the sea and enjoys the water, then regular swimming might be good.

Re: Carpal valgus 1 year old staffie

Mark Thirkell — Sun, 05 May 2013 01:10:38 GMT

Hi Rebecca.

The future does not sound good for the staffie. My approach would be initially to radiograph both front legs with a view to obtaining the opinion of your friendly neibourhood orthopedic specialist with regard to possible treatment. He is beyond the age when growth plate stapling or traction ring external fixationare likely to help. I suspect the advice would focus on some form of closing wedge ostectomy.

Mark