What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

Beats — Tue, 07 Nov 2023 16:39:43 GMT

Thanks, Andy - that's amazingly helpful - really appreciate the insights.

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

Andy Moores — Tue, 07 Nov 2023 09:54:39 GMT

Hi again Beats, John's comments were certainly prescient -that is a very abnormal shoulder and reduction was unfortunately always doomed to fail.

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

Beats — Sat, 04 Nov 2023 13:57:21 GMT

reduced2

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

Beats — Sat, 04 Nov 2023 13:53:36 GMT

reduced1 (cranial limb)

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

Beats — Sat, 04 Nov 2023 13:52:14 GMT

luxated2

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

Beats — Sat, 04 Nov 2023 13:51:22 GMT

luxated1

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

John Innes — Thu, 02 Nov 2023 11:15:12 GMT

Thanks for the more detail. I've used sutures and suture anchors for unstable shoulders in the past but these have all been adult (usually agility/working dogs). In theory, no reason why such techniques could not work in puppies. I've used arthrodesis for congenital luxations where function was poor and had very good success. I guess if the shoulder is left luxated at this age, further development of the joint will be affected (e.g. glenoid will not form appropriately even if it is OK now). Arthrodesis could be used at a later date to salvage things I guess.

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

Beats — Thu, 02 Nov 2023 10:42:41 GMT

Thanks, Andy and John for your expertise on this!

I chose not to bandage this leg and it popped out again 5 days later. Decision was based on I wasn't sure that a badnage would increase long term success that much in this pup and carried some risks both to the limb and to the pup's normal social development at important age - given it popped out again 5 days later I've since questioned if maybe I should have bandaged it.

Original injury occurred when jumping off sofa and other dog collided into from side at high speed when pup was landing and yelped and shoulder was visibly obviously dislocated to owner and brought on that basis. Was limping on it, but not overtly distressed - could walk, but held up when resting.

Interestingly it has been reported since that a distant blood relative of the pup a lot of years ago has a dislocated shoulder as a pup, so some level of genetic presdisposition sounds likely.

I'll try to post the xrays when I'm back at work next week as you might be able to spot changes to glenoid from normal (albeit the xrays might not be good enough for this). Felt quite stable when replaced and did stay in a few days.

Decided against cage rest as pups dont tend to cage rest very well and effect on normal social development maybe outweighed benefits.

Having popped out again, is walking OK, and owner not keen to do anything that might upset pups social development - the distant relative apparently did fine with its luxated shoulder, just couldn't be shown due to visible deformity.

I always find it hard to decide with pups at this age - have had a few over years where I've regretted excessive restriction and had a great fractured leg repair, but a pup that bites or has other problematic behaviours and might have been better with 3 good legs and less of my vet efforts on the leg.

How would you surgically stabilise this if that was being done at this age and how successful would that be with minimal restriction afterwards?

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

John Innes — Thu, 02 Nov 2023 09:38:16 GMT

Is it certain that this is traumatic? 11 weeks old could make this a possible congenital shoulder luxation maybe? These are typically medial. Is the glenoid well formed? If not, it might suggest this is congenital.

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

Andy Moores — Thu, 02 Nov 2023 09:36:57 GMT

Hi Beats, you are correct, limb in extension regardless of whether medial or lateral. Usually reduction of shoulder luxations is pretty straight-forward. The difficult bit is keeping the joint reduced. The Denny & Butterworth book illustrates a couple of sling options (Velpeau for medial, neutral sling for lateral luxation). Be very careful with a sling that you do not put the carpus into extreme flexion but have some soffban-type padding around the carpus so it is flexed a little more gently. Vascular injury to the distal limb associated with sling fixation is a risk. Another option is a spica splint (lateral splint from digits to dorsal midline, bandaged to limb and thorax) or, if the shoulder seems stable, crate rest. There are surgical options for recurrent luxations. Sling/splint support should be used for at least 2 weeks (with regular checks during that time) and a total of at least 6 weeks strict rest.

RE: What is the best way to reduce medial traumatic shoulder luxation in 11wk old fox terrier pup?

kathryn goldsworthy — Wed, 01 Nov 2023 16:29:02 GMT

Having experience of one of my own dogs who had a traumatic luxation of her shoulder-in her case the shoulder was replacing when she lay down with her leg in extension.

Treatment recommended was rest and she came back to full fitness able to compete in agility.