[Dailydrool] Young Charlie visits an orthopedist

[Elizabeth Lindsey]

As most of you know, our young Charlie is making his way through life  
with badly malformed front legs and feet. His legs bow and his feet  
turn out so dramatically that they end up in a perfect 180-degree  
first position whenever he stands up. The only thing keeping him out  
of a ballet company is the fact that he rolls over terribly on his  
front feet, which is a sign of bad technique and substandard  
training. It may also be a sign of substandard breeding, but I'm  
going to bite my tongue on that because it could be I'm just looking  
for someone to blame for what's happening to the basset who adds so  
much to my life.

Lately it's seemed to those who've known Charlie well during his five  
years with us that he's rolling over more on his front feet that he  
used to and that his front legs are bowing out more. He's also become  
really pokey while on walks, especially walks on pavement, which  
makes us think he's either trying to be the one in charge of the walk  
instead of us, or he's finding walking more quickly to be too  
painful. When I took him to the regular vet for a hot spot several  
months ago, I asked for a referral to an orthopedist. We wound up at  
Blue Pearl with an appointment with Dr. Au (pronounced "Awe") last week.

Young Charlie walked into the office and immediately charmed the  
receptionist and then the people in the waiting room. He charmed the  
vet technician who put him on the scale (19 kg), and then he really  
turned on the charm for Dr. Au and his intern. Later I could hear him  
charming everyone in the back on his way to and from the x-ray  
machine. Charlie may be a physical disaster, but there's a very  
engaging personality inside that messed-up body of his.

It always feels good when someone's obviously enjoying your dog, and  
I was glowing with pride over my delightful dog who was making so  
many new BFFs. Even better, several times during the visit Dr. Au  
commented on how well behaved and obedient Charlie is. So of course I  
told him how many obedience classes Charlie's been in, and about his  
dance classes as well. Dr. Au kind of blinked at that. I got the  
impression he doesn't see many trained dancers in his line of work.

Because Charlie's one of those who periodically bursts into  
spontaneous dancing--and especially enjoys dancing with me--it's  
important we get his feet looked at and treated so his dancing days  
won't end prematurely. Charlie was born sparkling with joie de vivre,  
and dancing has become his way of expressing that. I'm afraid Charlie  
would feel sad if he couldn't get his front feet and legs to do what  
he wants anymore. I know I'd grieve if he couldn't dance anymore.

Dr. Au did a manual manipulation of Charlie's feet, legs, and elbows,  
and then took x-rays. His intern performed the important function of  
sitting on the floor and ensuring Charlie's tummy and ears got rubbed  
while Dr. Au talked to me about what's going on with Charlie and what  
our options are.

He said Charlie's problem is called abnormal radius curves (carcal  
balgus was how he spelled it) and was caused by the radii growing  
faster than the ulnas, so the radii wound up bowing out and both the  
bones twisting around in the space between the elbow and ankle  
joints. This has resulted in abnormal spacing in his elbow joints,  
abnormal positioning of the elbows, his feet rolling over, and all  
the wrong body parts carrying the load of Charlie's front half. He's  
got a pretty good front half, too, thanks to a super-deep chest.  
Because his elbows are carrying most of the load and those joints'  
spacings are uneven, plus the osteoarthritis that showed up in the x- 
rays, Charlie probably does feel some discomfort when he walks for  
any length of time.

What are our options? Well, when you see an orthopedic surgeon, you  
sort of have to expect him to be brimming over with enthusiasm about  
doing surgery to correct a problem. In this case, a surgery called  
radial and ulnar osteotomy. Dr. Au said he could break Charlie's  
bones and reset them with rods and plates and an external metal halo  
brace that would encircle Charlie's lower leg and screw into it. The  
halo and rods, along with bone grafts, would make the healing ulna  
lengthen to better match the length of the radius, and the radius's  
length would be slightly reduced and in a way that would remove some  
of the bowing. Healing time would be about three months, and then we  
could have his other front leg broken and reset. Dr. Au said most  
dogs don't bother the halo, but we'd have to make sure Charlie isn't  
active while he's healing. Doesn't that just sound like fun for all  
of us?

The surgery resembles what Ken and I often joke about doing--lopping  
off Charlie's front paws and switching them over because when he lies  
down and crosses his feet, it looks like his feet are actually on the  
correct legs for a change. Our home job would be the most economical  
approach. Each surgery with the specialist would cost about $3,500,  
though Dr. Au said we might not have to do both legs. The result  
would be Charlie's elbows being repositioned so they're held closer  
to his rib cage (like they should be) and his shoulders assuming  
considerably more of their share of the load of body weight and  
relieving the strain on the elbow joints.

If we choose to do nothing more than give Charlie anti-inflammatories  
for the rest of his life, we might end up having to make a hard  
decision about allowing his life end if he's in too much pain or  
depressed by an increasing disability. Dr. Au also said that it could  
be that Charlie stabilizes on his own and does just fine as he is for  
the second half of his life (he's six now). We're also reminding  
ourselves that Charlie could die of cancer instead, or bloat, or by  
being hit by a bus tomorrow. Without a properly working crystal ball,  
there's really no telling what will be the cause of Charlie's  
eventual end. How do we even begin to make an educated guess on this  
one???

The one thing I feel good about is that we've done everything within  
our power to keep Charlie's physical deterioration to a minimum. He  
sees a chiropractor a couple times a y ear, we keep his toenails  
trimmed and his weight down, and he doesn't do stairs or jump on and  
off furniture (except for our bed once a month or so when he's  
feeling ignored, because negative attention is better than no  
attention at all). Dr. Au said ideally this kind of surgery is done  
before a dog is ten months old, which was the age at which we started  
fostering Charlie, so we were already too late before we'd even begun  
with him. With our late Jane Basset, I never knew if we were the  
reason she had ruptured disks or not. But we learned from her what  
not to do, and so I feel no guilt about Charlie's condition like I  
continue to do about Jane's.

Ken and I are squeamish about the surgery Dr. Au described. To  
deliberately break a dog's leg bones? It's pretty drastic, in  
addition to being very expensive, though it sounds as if the  
complications are a lot less dire than those for disk or TECA  
surgeries (Jane's specialties). Fortunately it's not a condition we  
need to make a quick decision about. We have time, and we're going to  
use some of that time to get a referral to an orthopedist at our  
state's vet school, a research institution, for a second opinion.

Dr. Au gave us some Dermaxx for those times when Charlie seems to be  
feeling achy. It's hard, though, to tell when he might be feeling  
achy. Bassets tend to have a high pain threshold. As soon as we get a  
couple of days of no rain, I'm going to take Charlie for a good walk  
one day, wait a day, and then give him a Dermaxx about an hour before  
another good walk and see if I can detect a difference.

In the meantime, Charlie continues to ask me to dance with him at  
least once a day, and he continues to meet his quota of one naughty  
act per day, so he can't be feeling all that bad. Today's was raiding  
the paper recycling box, so now we have torn-up paper all over the  
house.

If anyone has any words of experience or wisdom about the surgery Dr.  
Au described, I'd love to hear them. Also, does anyone know if they  
make wheelchairs/go-carts for dogs with front-end mobility deficiencies?

Elizabeth