Hi All

My puppy had an accident yesterday, he got up onto our armchair and onto the windowsill and fell off onto the floor hurting his back leg, i took him straight to the vet yesterday lunchtime and they gave him a painkilling injection said to see how he went overnight and to take him back this morning. He won't put any pressure onto the leg he is just holding it up all the time, i took him this morning and they kept him in for x-rays and i had to go back this afternoon to collect him, the vet said that the tibial bone has slightly moved to the other back leg on looking at both x-rays while there she said that it is only slightly moved but she is concerned that if it is not fixed it could stump his growth, she has sent him home with a heavy bandage to keep the leg as straight as possible and i have got to go back Monday morning to possibly leave him to have a pin put into the leg, she has said he needs a tibial tuberosity pin and wire, this will be in for around 3 to 6 months in which time the bone should hold into place and then he will then have to go back in and have the pin removed in about 6 months time. What i am a bit worried about is he is only 5 months old and the operation she said will take around 1 and a half to 2 hours, i know if he needs an operation he has got to have it but i am wondering whether the bone may move back on its own, i asked her if it may heal on its own how long would it take and she said around 3 weeks but they are planning to operate on Monday morning so i am not sure whether this is too soon after just bandaging it tonight it will only be in the cast for 2 days. Has anybody else had this happen to their dog that they may be able to give me some info on, i am just trying to find out as much as i can.
He is a west highland terrier, the vet said that it is the bone around the kneecap that he has damaged and that it is a common injury in puppies jumping around.
Hope somebody may be able to give me some info
Thanks
Helen

So your pup has to be wired/pinned for 6 months well i have never heared this before? i would ask to be reffered to a specialist in skeletal disorders is your pup insured.Jackie

Hi Jackie

Yes he is insured with Petplan, the vet said that if the joint is not pinned and wired the as he moves the kneecap this will cause the misaligned joint to keep moving out of place, they said that they usually remove the pin and wire after 6 months because they are usually not needed to stay in for the whole of the dogs life. I am concerned about a big operation at the age Hamish is because of the amount of anaesthetic that he will need for that length of operation. I know if he has got to have it i will have no choice but i wanted to see if anybody else had been through this with a young puppy. He is getting around okay tonight although his leg is strapped very straight and making it a bit difficult for him but he is lively enough and eating/drinking fine so i will just have to see what the vet says on Monday morning and go from there. The vet he is down to see has done a lot of these operations on young puppies i have been told so hopefully he may be able to answer the questions that i am going to ask, i just feel that if there is a chance the bone will go back on its own as it isn't broken she said it has just moved slightly compared to the xray she took of the other back leg.

Helen

I don't quite see how a bone can move without being either cracked, broken or dislocated. If dislocated then it would not be pinned. It would usually be relocated and movement restricted for a while.

Any pin in a bone should always be removed once the break has healed. Imagine for a moment a side load on a bone, it breaks! Now imagine a side load on a bone which has been pinned down the center. the pin bends but the bone cannot bend so literally shatters! A far worse injury! I was silly enough to race for several years with a pinned leg! (And lucky enough to get away with it!)

Regards John

Hi

Thanks for your replies about Hamish, i too am a bit concerned about him having surgery, the vet said that the bone that has slightly moved where he is a puppy it has not fused properly and this is why it needs to be pinned and wired to stop it keep moving when he bends the kneecap, sorry if i am not explaining it very well but i don't really understand bones in animals that well. I assumed that a bone was only pinned if broken!!
Does anybody know how i can get details of orthopaedic specialists in my area, i have been looking on the web but cannot find any lists, i live in Hampshire. Any advice i would be very grateful for.

Thanks
Helen

Hi Helen
Sorry to hear about your puppy.
One of my, now long gone, cavaliers had a 6 hour op when she was 5 months old, to pin the 1st and 2nd cervical vertabrae. We were told she only had a 3o% chance of recovery, but had to have to op, as she kept collapsing.
She went to Langford House, the Bristol Veterinary Training Hospital,by referral, and it was a complete success, even though she had to wear a neck brace for 2 months, and be cage rested. She lived to 12, with no further neck problems.So, if the op is totally necessary, the op shouldn't be a problem. (I would want a specialist opinion though, as the other people on here have said, before I agreed to anything.) I lost a beautiful healthy 5 year old cavalier last November, who had a bad reaction to the GA for a slipped disc removal....I wish I had insisted on a specialist then.......

There is an orthopedic specialist in Devizes, Wiltshire...I think his name is McQueen.

Thinking of you and Hamish

Sami

I don’t know where abouts in Hampshire you are but I figure that the M25 can’t be that far away. In which case you could ask your vet for a referral to the Royal Veterinary at North Mimms. It is less than a mile from the M25.

Regards, John

Hi Shane

Please don't go ahead with this kind of surgery at your local vets. I too would ask immediately for referral to an orthopaedic surgeon. The one i've used in the past is in Tenterden in Kent. Gary Clayton-Jones of the Highland Surgery. Don't know if there is another nearer you, but I would say the travelling would be worth it for this to turn out well. Not saying that your vet can't do it, but I tend to think of vets as GP's, and feel that some things need a specialists attention.

Ask them to refer you as an emergency.

Good Luck
Kat

Helen,

My Cairn, who is now 10 months, rolled off the sofa when she was 5 months old. One of the growth plates on top of her tibia was pushed out of place and partially cracked and shattered. This sounds similar to your puppy - at 5 months the growth plate would not have fused to the tibia because it is still growing.

My vet referred us to a specialist. She had surgery - definitely did not take 1-2 hours - in which the growth plate was repositioned on top of the tibia and a simple, bent steel pin inserted to keep it in place. According to the specialist, the pin could have stayed in place forever, but he actually needed to take it out a month later because one part of her tibia (the part with the undamaged plate, there are 2) grew more than the damaged part and the pin started to move.

Years ago my sister's Cairn injured himself the same way at about the same age, a bit older than mine - he's nine now and right as rain, with pin still in leg.

I would try to take your pup to a specialist - and it's important you do this as quickly as possible. I know the one I was referred to put Abby on to his schedule ASAP because she was a puppy and still growing. This is in Guildford, Surrey, but the vet was very helpful and might be able to give you a referrel - his name is Noel Fitzpatrick and the surgery number is 01483 570782. He lectures frequently so I suspect he will have good contacts closer to you.

Stacey

P.S. My Cairn's leg is absolutely perfect now, but I have to say keeping her confined while she was healing was a test of my patience that I would never like to repeat. Good luck! :-)

P.P.S. I asked the vet if there were any effects of leaving a pin in place forever. He said absolutely none. No more chance of arthritis or any other negative effects.

it sounds as if this is what we call in humans a "slipped epiphysis" .....this means that the growth plate on the bone has moved. (ask your vet if this is what they meant) .we dont strictly call it a fracture, tho it is part of the bone. it is the growing part. it detaches from the end of the bone where it usually sits. (search the internet using the word "epiphysis" and you will find information.) if a slipped epiphysis is left uncorrected the leg concerned will not grow any more..but the others will, leaving it with one stunted leg. a sibling of my affie had this, and i have treated it often in humans. i agree, get an orthopaedic specialist vet to review. i know the other posts are well meant, but if they are thinking of bone fractures and not epiphysis problems,any advice they offer as to not having the op is not accurate.....this is much more complex than a straightforward fracture.

in summary,
clarify with your vet if this is an epiphysis(growth plate) problem.
ask for an orthopaedic specialist review

hope this helps!let us know how you get on!

if a slipped epiphysis is left uncorrected the leg concerned will not grow any more..but the others will, leaving it with one stunted leg. a sibling of my affie had this, and i have treated it often in humans.

Not sure - because I don't have pinklilies' professional knowledge - if my whippet puppy's injury was exactly as described but the x-ray showed the growth plate in his wrist had been pulled off by the tendon, in play. His wrist was the size of a golf ball but because he was sound, no judge noticed (couple commented that he had a lot of growing to do :-) ) and he won several BP at ch level. Vet prescribed lead only exercise which was not easy as I also had a sibling but as he predicted, the problem went away (don't ask me how!), he grew normally, won a CC and Res CC and also the premier whippet coursing stake (OFC for our transatlantic friends). I would have thought that pinning/plating a growing leg would be more likely to produce stunting or other deformity.

Caro

Hi Caro,

"I would have thought that pinning/plating a growing leg would be more likely to produce stunting or other deformity"

Nope. Pinning keeps the bone properly positioned and aligned with the growth plate so the bone can grow properly - if not, it can lead to a deformity where the leg is twisted or bent because of bone growth in the wrong direction or stunted - with ligaments pulled and twisted as a result.

In growing bones, pins or screws are placed so they actually allow for continued bone growth - which is why it is important not to leave this type of operation to a general vet. When my Cairn was treated the vet x-rayed every two weeks to check on growth of the bone and to see if the growth plates were fusing or not. He knew how much bone growth was left based on what he saw in the X-rays, but the question for my Cairn was whether or not the damaged growth plate would continue to grow or not. If it had not, but the undamaged one continued to grow, then potentially she would have gone lame and needed further surgery when she was fully grown. Luckily, when she broke the growth plate at 5 months she had very little growing left to do and even thought the damaged plate grew less than the undamaged one it did not matter.

Stacey

HI All

Thank you to everybody that has replied concerning Hamish, the latest news is that he went back in on Monday to have the bandage off and to be re x-rayed, the vet has decided to leave him in the bandage for another 10 days as he felt all around the area once the bandage was off and Hamish did not react to any of the pressure that he put on the leg which the vet said was a good sign because usually they cry when the leg is touched, he said that as the bone has moved a fraction he does not want to operate at the moment as he feels it has not moved enough to warrant surgery at this point, he is hoping with the leg being kept straight that the inflammation around the growth plate will have chance to heal, he is on Metacam medicine once a day, he has got to go back on Friday for the vet to check how he is doing and then in 10 days when the bandage comes off he will have to be kept in 1 room so that he does not over excite himself and not to jump up, this is hard as he is tearing around the house at the moment even though the leg is in bandage it doesn't seem to be restricting him very much. He is eating and fine in himself, you wouldn't know there was anything wrong with him other than his back leg is bandaged.
He said that he cannot say whether there will be damage to the growth plate at this time because as he is only 5 months old we won't know for definite until he gets older, i must admit i am concerned about how this will affect him in later life as he is such a young dog but i guess only time will tell.
The vet said that if the growth plate has been damaged it will mean that this little bit of bone will not grow fully to fuse together with the kneecap so he may have a slight gap, i don't know what will happen about this but i am going to ask him when i go back on Friday, the trouble is when you are there you try and take in everything they are saying and questions come to you when you have left. So i am going to ask these when i go back.
I am just hoping that once the bandages come off in 10 days that he will start to use the leg again, this is my main worry incase he starts to hold the leg up again like he was when he did the accident, with the bandages on he is putting pressure on the leg but i guess this is where he is being supported. We cannot get the bandages wet so have got to put a bag over the foot when he goes out to wee, and of course all the dry weather we have had, now the showers have turned up typical!!!
I will let you all know how we get on, i am going to ask for a specialist referal if when the bandages come off he still cannot use the leg but the vet feels that bandaging it for 10 days will give him the best chance possible to avoid surgery, not sure whether this is the normal thing they usually do before resulting to surgery but not knowing much about bones i have got to put my faith in him that he is doing the best for Hamish in the long run.
If anybody can give me any advice about the growth plate being damaged and what problems this could cause as he gets older i would be very grateful.

Thanks
Helen

Helen,

Please take Hamish to an orthopaedic specialist for a review of his X-rays. If the swelling went down it is not an indication that the growth plate was not damaged. The swelling will eventually go down in any dog with a broken leg. It heals by itself, but with a break not usually in the correct way.

I have Petplan and they were absolutely brilliant - paid everything with regard to the referral, operation and follow-up visits for Abby.

While Abby was recovering from her growth plate injury I happened to watch one of those vet programs on cable. I was astounded to find that one part of the program was about a Cairn that had injured it's growth plate. The owner did not know and she did nothing until there was an obvious problem as a result, months later. This Cairn's left hind leg looked absolutely terrible. Not only was he limping, but the bone in the leg was actually bent into a cresent shape. That's what happens if the growth plate is injured and does not continue to grow properly. The bone heals, but the growth is uneven and the ligament pulls on the bone - and in this poor dog's case, actually caused the bone to bend out of shape. He needed surgery to fix it. Much more difficult and with less chance of success later on.

If Hamish were my puppy, I would get him to an specialist ASAP, just for my peace of mind if nothing else. Bandaging is not going to do a thing is his growth plate is no longer in proper alignment, all it will do is increase the chance that the plate will adhere to the bone in the wrong position and the bone will grow incorrectly. When I asked my regular vet if she could just push Abby's growth plate back into alignment she looked at me like I was mad and told me flat out that it could very well mean Abby would end up with a deformed leg.

I don't mean to scare you. No, that's a lie, I do mean to scare you. :-) It is not worth risking Hamish's leg and more risky surgery - all because you hesitated to take him to a specialist.

Stacey

Hi All

Just to give an update on how Hamish is doing, i took him back yesterday afternoon because the bandage had slipped down the leg a fraction and it was making it difficult for him to get around, the vet re aligned it and i have got to take him back on Monday morning. I asked the vet exactly what bone had moved, it is not the growth plate that has moved slightly it is the tibia, this is why they were talking about doing a tibia tuberosity pin and wire, but the vet said that from the xrays that he took the bone has only moved a very small amount and he feels that surgery is not needed, he said that immobilising the leg for 10 days in a heavy bandage should do the trick and he feels that he will make a complete recovery, he said that if the bone had moved a lot he would have carried out the pin and wire but he does not think that it is necessary. I asked him if the growth plate would have been damaged but he said he cannot say for definite but hopefully he the leg will heal okay and we will have no other problems. I am not sure whether this is of any help to the people that have replied to me but i wanted to ask him if it was the growth plate that had moved as some people had replied asking this. He said it is where the bones have not all fused together yet that this 1 has moved slightly from the fall.
He advised me to cut back on his Metacam and see how he goes so i halfed his dose last night but will have to see whether he can cope on a lower dose.

Thanks
Helen

Helen,

Just so you know, the procedure Abby had for her broken bone was a tibia repair. The growth plates sit on top of the tibia (the knee). "He said it is where the bones have not all fused together yet " - this is exactly where the growth plates are located. If you looked at an x-ray of Hamish you would see something like a thin clear-looking line on top of the tibia. That's the area between the tibia and its growth plates. When the bone is fully grown this line disappears because the growth plates have fused to the tibia.

If your vet has not realigned the bone, which he has not from what you have said, and is not sure whether or not the growth plates are damaged ... well, you know what I would do. It's good to trust your vet, but unless he has years of experience with similar injuries his may not be the best.

Stacey

Hi Shane

As another poster said - it's good to trust your vet, but remember they are General Practitioners and not specialists. If this were me I would be at that specialists pronto. That way you can confirm whether your vet is correct, and feel confident that you have done all the right things to get the best outcome. If you don't and things go wrong you'll feel no end of guilt (at least I would). Also I believe the sign of a very good vet is to make the call to refer to specialists when it is appropriate. It would worry me to leave this and "see how it goes" it could be too late by then. If you go to a specialist and your vet is right - then no harm done! Especially if you're insured and cost is not an option, what are you waiting for?
Good luck
Katrina

Hi All

Just an update on how Hamish is doing, he had his bandage off last Monday when he went to the vets, we have had to rest him in 1 room all week and take it very careful with him. He had to go back to the vets on Friday morning for a check up, the vet was very pleased with him both knee's feel the same and he is walking okay on that leg now, he stayed on his Metacam until Friday evening then we have had to stop the dose and see how he goes, he has now started to go out for very short walks and i am very pleased with him, he is running around and using the leg fine like he used to, since cutting the Metacam out completely he does not seem any different at the moment so i am keeping my fingers crossed that he is well and truely on the mend now. I have got to keep him in 1 room until tomorrow and if he is okay by Monday i can then let him have the run of the house as usual, i am taking him out around 4 times a day for just a short walk at the moment to gradually build him up, but no running at the moment, he is just so lively it is very hard to keep him quiet.
He is eating fine and running around enjoying himself and he seems fine in himself so i am hoping that he will be okay, the vet wants to see him again next Friday and he said if we have got no problems by then he will not want to see him anymore, it is just taking it day by day with him but i think we are now over the worst, fingers crossed!!!
I want to thank everybody for their replies about Hamish and i will let you know how he goes throughout the week, but as i say he is as lively and as happy as ever rolling around and running about just like a puppy should be. I thought he may start to hobble again when the bandage came off and especially when we had to cut the Metacam out but he has been walking as normal and not holding it up at all so he cannot be in an discomfort.

Thanks
Helen & Hamish

I am glad Hamish is on the mend - thanks for letting us know

Gina :p

Thanks, Stacey, for explaining the pinning puppy bones procedure - makes sense like that :-) I was alarmed, like others, at the thought of a general vet sticking in a pin and leaving it for six months. Hope Hamish gets to see a specialist if he's not OK at the end of the week.
Caro

Glad to hear your puppy is on the mend.
Budmag

Hi
Our 4 month old Boxer puppy had the same problem 6 weeks ago and the vets were going to pin her leg but after x-rays found that this was not needed and she had a cast. This worked fine and her leg is now much better now. So i'm glad to hear you didn't have to go through all of that treatment too.