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The carpal, or wrist, joint in a dog is susceptible both to injuries and arthritis. These issues can lead to the deterioration of the joint beyond repair. This occurrence is very painful for the dog, and can be determined by limping and hyperextension of the affected paw. The dog will likely allow the paw to hang, drooped downwards as it walks.
To treat this problem, a procedure called arthrodesis can be used. This is a surgery in which the cartilage in the joint is removed, and the joint is permanently fused together. A bone graft is used to ease healing while metal inserts are placed to secure the position of the fusion. The bones can then heal together, which greatly reduces the amount of pain that the dog experiences. An arthrodesis is generally used after a three-month trial using a leg splint has failed. It must be performed by an ACVS board-certified veterinary surgeon.
Prior to surgery, the joint will need to be checked for infection. If any infection is present, it will need to be treated before the joint can be operated on. Pre-anesthetic blood work will have to be run to assess the dog's overall health condition. X-rays can be used to plan the positioning of the joint fusion. It is at this point that the surgeon can determine whether a partial arthrodesis, allowing some joint movement, or a panarthrodesis, allowing limited to no movement, is appropriate.
To begin the surgery, an incision is made into the affected leg. The cartilage in the joint is then fully removed. A bone graft is then harvested and placed into the joint. Next, the bones will be positioned and securely affixed using metal plates, screws, pins, wires or external skeletal fixators. Once this is completed, the incision can be closed using sutures or staples.
The vast majority of dogs who undergo an arthrodesis recover very well. It is a permanent procedure that is extremely effective for reducing pain. In many cases, both partial and panarthrodesis allow good movement in the affected joint. The only alternative treatment involves the use of a lengthened period of leg splints. It is not as effective, as the dog often re-injures the joint.
The dog will need to be monitored during its come-down from general anesthesia. Pain medication can be given intravenously at first, followed by oral medication upon discharge. A leg cast and or splint will be used to stabilize the joint through the healing process. A veterinary appointment will be needed every one to two weeks to change the padding and dressing on the leg for six weeks. At this time, the cast may be removed.
The dog should not be allowed to move much, being kept on leash during bodily function relief. Exercise can slowly increase after the cast has been removed, allowing the muscles to gradually rebuild. X-rays of the joint will be needed four weeks after the surgery, and then again at eight weeks. A full recovery is generally seen by four months post-operation.
The price of an arthrodesis can range from $1,000 up to $5,000. This is due to the need for general anesthesia, diagnostic imaging, and medication after the procedure has been completed. If a specialist has been used to perform the arthrodesis, costs may be significantly higher.
The alternative to an arthrodesis is splint management, which is not often successful. While it does cost less, in most cases an arthrodesis will be recommended once the animal re-injures itself. In older dogs who are not good surgical candidates, aggressive pain management and supplementation may be suggested. This can be quite expensive and may damage the internal organs if used for a long period of time.
As with all surgeries, complications may arise from the use of general anesthesia. These issues are uncommon in healthy dogs, and can be reduced by the close monitoring of the dog in the recovery period. Rare complications from arthrodesis include severe cold sensitivity, pressure sores, or infection of the surgical site. A failed fusion or the breakage of metal implants can result from heightened physical activity before the healing has completed. Both of these issues would result in a second surgery being needed.
There are things that can be done to prevent the need for arthrodesis in dogs. Severe injury can be reduced by keeping your dog on a leash during walks. You should also prevent your dog from jumping from heights, as this can greatly damage the joints. To lessen the effects of arthritis, watch for any limping or stiffness after play or exercise. Take your dog to the vet at the first sign of chronic pain. Treating arthritis early with daily supplementation of glucosamine and chondroitin may slow down joint deterioration.
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