Pet Patients Angular and rotational limb deformities: Slumdog has his day in the OR

I have the best luck. My veterinary surgeon boyfriend holds a rarefied kind of certification human and veterinary surgeons share. It grants him the ability to perform research and lecture on all kinds of fiddly limb deformity-fixing techniques. Yesterday his talents came in very handy.

Slumdog is the newest addition to my family. Every bit of this puppymill pug mix signals that he’s worthy of his name––not least of all his painfully twisted limbs.

When Slummy (AKA, Mumbai, Smeagol) runs, he falls. When he jumps, he lands all wrong (on his face, usually). When he walks, he uses a unique gait more akin to an equine pacer’s trot than to a proper dog’s. The toes of his forelimbs splay out like a duck’s (for increased stability, presumably). In three years,’ time, his wrists and elbows will increasingly fail him. They’ll be feeble and arthritic. Without pain relievers, they’ll hurt all the time.

Here's are his legs:

That’s why we finally decided to put him through two painful procedures designed to right the wrongs his “breeders” committed in creating this canine aberration. (We suspect a puggle-puggle outcross––a stupid human trick no one should attempt after observing my Slumdog as specimen.)

Here’s what the X-ray of his left leg looked like before (the straightest we could get it):

The first of the surgeries took place yesterday morning. After weeks of X-rays and measurements and digital reconstructions of his twisted limbs, Dr. Wosar was ready. In a two-hour procedure, Sumdog’s most twisted upper forearm was incised.

There, he received two neat slices to each of the bones beneath (radius and ulna).

The bones were then repositioned based on his degree of abnormal rotation and altered angulation, then plated together.

Here are his post-op rads:

Yes, LOTS of pain relief throughout.

Indeed, this is was a stressful surgery for me. Sure, it’s always hard for a mom to watch her own go under the knife, but it’s even worse knowing that the suffering is only necessary because of all we humans have actively done to turn dogs like him into abnormalities––all in the hopes of producing a profitable product. Worse yet, someone along the line almost certainly cashed in.

Sick, right? All so he could undergo two $5,000 surgeries.

Now the clincher: How many "purebred" dogs suffer as he does? After all, Slumdog’s degree of abnormality may be severe, but it’s not unique. I’ve seen plenty just as bad over the years. And they all deserve surgery. But who can afford to pay like this? I certainly can’t. I just happen to have gotten lucky. Slumdog, too.

October 10th, 2009

Add Comment60 Comments

That is no less than amazing! Wow.

He is so adorable!

I'm wondering how much time is expected for his leg to fully heal & what you expect for post-op pain treatment?

Barbara A./NH October 10th, 2009 08:25:03 AM

Barbara: He stayed on a fentanyl drip overnight and now he's here at work with me. Now he'll need to keep this splint on for a few days. It's not to keep it stable (the plate does that well), it's to keep his paw from swelling since the de-rotation of his wrist (the upshot of the upper limb straightening) cramps the blood vessels and lymphatic drainage system for a little while.

He'll need to remain in a crate for most of the day for the next three weeks and he can't jump (AT ALL!!) but he can walk around while attached to my hip (literally, I'll keep him tied to me on a leash). After all this work, I'll be taking no chances.

Pain relief-wise, he'll need very few meds now. Just some Rimadyl every morning for the next week or so. He's really comfortable now. I may add in some tramadol if he seems to need it. Right now he's still a little loopy from the fentanyl but when it wears off we'll see...

Dr. Patty Khuly October 10th, 2009 09:57:41 AM

Heroic mom, dr. bf and doggy all.

May Slumdog recover quickly to test his beautiful limbs.

oh holland October 10th, 2009 10:17:41 AM

He is gonna be one confused little fella until he adjusts. And then the second time!

What a lucky pup, to end up with you. Not so lucky in his genes, unfortunately. Still. Looks like he got the best home possible.

(Thanks for the pics. Fascinating. To be able to FIX something like that, wow.)

Galadriel October 10th, 2009 11:06:02 AM

What a lucky pup, to end up living with people who can fix his legs. Hope he has a speedy recovery.

Julie October 10th, 2009 11:56:33 AM

Best wishes to Mr. Slum for a complete speed recovery. You both are very lucky indeed.

tripawds.com October 10th, 2009 12:00:32 PM

Aw, poor little fella. But he's also a lucky fella. Best wishes for his recovery and glad you kept his name :)

PJBoosinger October 10th, 2009 12:14:45 PM

Speedy recovery to Slum Dog.

Jen October 10th, 2009 12:22:18 PM

You are beautiful, Slummy!

Dee October 10th, 2009 01:19:52 PM

Hope he has a speedy recovery. He's a lucky guy to have you.

Carol October 10th, 2009 01:28:33 PM

Dr. K: Same as Pearl--she received morphine type IV post-surgery, and went home with fentanyl patch, after that it was a short course of pred. because she had been on that pre-surgery.

It is nothing short of awe, to think those legs are reconstructed! Talent.

Ok, with his new "look", please consider a new name---his face is priceless!

Barb A. October 10th, 2009 01:37:34 PM

A heartwarming story for sure.

This reminds me of Eve ,a foster dog we had that was a pure Belgian Sheperd who's owner had to go to a nursing home.We found out that she had a mammary tumor just when someone across the country expressed interest.It turns out that this person had shown dogs and knew Eve personally..she was also a vet and had no problem taking her and treating her cancer.Eve is now living happily in Idaho after being fostered in upstate Ny.

Thanks for providing the best possible home for Slumdog.

Susan H October 10th, 2009 02:28:14 PM

"Now the clincher: How many purebred dogs suffer as he does?"

Why the emphasis on "purebred" dogs? You state he's a mix, thus not a purebred dog. Bad breeding is bad breeding, irrelevant of the breed(s).

KB October 10th, 2009 04:19:11 PM

Looks real nice!!!

barri October 10th, 2009 06:32:38 PM

Aaaaawwww, what a darling face. Really, you think puggle-puggle cross? He looks so pug to me. But the legs, yes, what poor breeding. That makes me sad.

Kudos to the BF, what a hero he is for Slumdog! It makes me hopeful for my own pug's knee surgery coming in January.

Sonya W. October 10th, 2009 07:30:55 PM

KB: Purebred in quotes. Mea culpa. I've amended it.

Dr. Patty Khuly October 11th, 2009 07:14:32 AM

Sonya: A puggle-puggle cross would produce a variety of different pug or beagle "looks." They rarely look like puggles, as they tend towards a recombination of genetic material that does not maintain that half beagle-half pug look. They do not breed "true," as they say in breeding circles.

Dr. Patty Khuly October 11th, 2009 10:15:12 AM

I'm very happy that Slumdog lucked into you! Is he having both legs done at once, or one at a time? And what are your rehab plans? 'Cause he's going to need a lot.

I would just throw in a plug for Dr. Gillette over at Auburn. I haven't ever needed to use his services -- my ortho vet is closer & a good friend -- but reputedly he does good work with biomechanics... and Mr. Slumdog is going to have to learn to walk again! Even better if you have a biomechanic vet closer to you. =)

Julie in OH October 12th, 2009 03:36:09 PM

P.S. Processed my first chicken yesterday evening. It was less traumatic than I expected, so I figure that means I didn't botch it too badly.

Julie in OH October 12th, 2009 03:41:37 PM

Julie: Congratulations! One less chicken that suffered the life of a factory farmed bird.

Dr. Patty Khuly October 13th, 2009 09:00:34 AM

i feel so for Slumdog....it's great that he's lucked out in landing with you...but the poor guy! My pittie, Beaner, had tightrope back in June....it's SO HARD on the dog.... He had pain control, but still---- it was the toughest week and broke my heart to see him in such pain.....

Now, the leg that was operated on is super! But his other leg needs surgery. I am still paying off the first leg, plus building up vacation time to take off to get his other leg fixed. It's not just the money and time, but it's what he has to go thru that makes this so hard.

That said, I hope to get his other leg done after the new year....he barely puts weight on it and it's really hard for him to get up and down....

My biggest reason I hate putting him thru this again...he was NEVER afraid of the vet until he had this done. Now he crawls and shakes....

With all the advances we've made for animal welfare, why is it we aren't allowed to be with our pet when they are put under? I know it would benefit Beaner.... I mean we acknowledge all other areas of our pets' feelings....why not that they need to be comforted and calmed when being knocked out?

agadoresmama October 13th, 2009 12:32:17 PM

Agadoresmama: I, for one, sneak out well before mine go under. For me, it's clear I'm doing more harm than good by standing around. The staff is inevitably more nervous and jumpy. Distracting the staff with my emotions is ultimately not helpful.

having said that, owners who ask are almost always allowed to watch surgeries. We have a window for that. More on this tomorrow, I think. It's a good topic.

Dr. Patty Khuly October 13th, 2009 02:55:34 PM

Dear Agadoresmama,

I have found that taking the dog to the vet, with a bag of yummy treats, when NOTHING will be done to him is a good way to get over that "fear of the vet."

The staff love it -- they are very pleased to love on him and give him treats. If they aren't busy, they will take him in the back and give him treats back there, too.

I have done this with multiple dogs. It has helped all of them avoid or get over being afraid at the vet.

I'm known as the owner who always has a baggie of Cheerios............

:-)

-- Vicki

Vicki in Michigan October 14th, 2009 10:20:31 AM

Toy dogs with short legs, short faces, and heavy builds tend to have some bowing. Your dog is rather severe. I don't know of any explanation but it probably originates with things like the glenoid version, inclination of the humerus, and dynamic stability of the shoulder capsule. The shoulder then dictates some constraints on the muscles crossing the humerus and elbow. This is just a guess and I am not an expert. I doubt there have been many studies on the etiology of forearm deformities in dogs. Even the etiology of patella luxation has rarely been approached. The majority of what is known is from one thesis in the 1960s.

Splay foot seems to be an almost ubiquitous feature of some wrist abnormalities. It must be the result of some muscles like extensor digitorum communis. The digits spread with extension of the palm. Do a handstand and then walk on your hands and see what happens.

Your dog may be rather severe, but generally, a more moderately crooked forearm usually doesn't seem to be a horrible problem. Peke, shih tzu, tibetan spaniel, and so on, often have such arms and only a few develop a really serious loss of function. I would be equally if not more worried about the potential for cervical pain and ivdd. When these type of dogs jump and land, the motor pattern for deceleration is never going to be quite right. How often do you see these cobby little dogs with degeneration of the wrists as compared with the frequency that you see them with serious neck and back pain?

-Eli

Eli R (wisconsin) October 17th, 2009 01:33:41 AM

Oh, I'm so sorry your pup had to go through all this, Doctor. I wish you the best of luck during recovery. He's lucky to have you both.

Best wishes,

Daniela

www.TheDailyTail.com

Daniela Caride October 17th, 2009 07:26:31 PM

Eli, I have to disagree with you on almost every point you make. There has been a large volume of research done on the etiology of both forlimb deformities and patella luxation. The evidence for forelimb deformity is very clear, and is the result of premature closure of a growth plate. Which growth plate closes prematurely dictates the direction and degree of deformity, with various patterns noted based on which plate is injured and when. The chiropractic theories of shoulder muscle constraints has never been shown to be a factor.

Furthermore, the incidence of carpal and elbow degeneration in breeds with these deformities is arguably 100%, as they all get some element of arthritis. The fact that it usualy is not a "horrible problem" or leads to "serious loss of function" does not mean it is not present. It is a pretty low standard to consider a problem worthy of consideration only if it leads to a serious loss of function. These dogs live with pain in their elbows and carpi, and since it is usualy bilateraly symetrical, they cannot even limp to show you their pain.

Patellar luxations have a similar etiology, with a torsional and angular deformity of the entire limb, leading to malalignment of the quadriceps mechanism and luxation of the patella. Again, the research is clear as to the etiology, and is not based on a single 1960s thesis. To sugest that is insulting.

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Hello ..I have a Lhaso mix that we adopted from the shelter and found out today he is going to have to have this surgery. If you dont mind, please let me know how things continue for Slum...and congrats on the surgery. We hope our Larry does well too.

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