Developmental Orthopedic Disease - Knuckling Over

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UNDERSTANDING THE PROBLEM:

YOUR PUPPY SHOULD NOT BE KEPT ON SOLID CONCRETE, TILE OR WOODEN FLOORS WHERE THERE IS NO SURFACE TEXTURE FOR THEM TO GRIP WITH THEIR TOES, AND USE THEIR MUSCLES, LIGAMENTS AND TENDONS PROPERLY.

REMEMBER THE FRONT END OF A DOG SUPPORTS THE BODY WEIGHT, THE REAR PROPELS THE MOTION, SO THE FRONT END MUST HAVE TRACTION.

SLICK SURFACES ALONG WITH LACK OF EXERCISE AND NUTRITIONAL MONITORING, WILL CONTRIBUTE TO "BOWING IN" AND "KNUCKLING OVER" ON YOUR PUPPIE'S FRONT END ASSEMBLY.

WHILE YOUR DOG IS IN THE EARLY STAGES OF DEVELOPMENT (UNDER 6 MONTHS), IT IS BEST TO PURCHASE RUBBER-BACKED THROW RUGS (NO FRINGE AND NO CONTINUOUS LOOP CARPETING, IN CASE THE CHEW IT), SO THEY HAVE SOMETHING TO GRIP WHEN WALKING AROUND, AND YOU CAN WASH THEM WHEN NEEDED.

JC PENNEY'S AND KOHLS HAVE GREAT BUYS ON THESE KIND OF RUGS FOUND IN THE BATH SECTION OF THEIR WEBSITE OR STORES. ANOTHER SOUCE IS THE LOCAL GOODWILL OR MISSION STORE. REMEMBER, NOW IS NOT THE TIME TO WORRY ABOUT "DECORATING" YOUR HOME, YOU PURCHASED A PUPPY AND NOW IT'S NEEDS MUST BE MET, MUCH LIKE HAVING TO HOUSE-PROOF YOUR HOME FOR A TODDLER.

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The term Developmental Orthopedic Disease represents a variety of conditions that occur in young developing canines. Usually this is a problem that occurs in large and giant breeds, but I have seen cases in smaller dogs as well. I will list the conditions in the order in which I have seen them occur in young puppies.

1. Carpel Flexural Deformity or "Knuckling Over or Bowed Legs "
2. HOD - Hypertrophic Osteodystrophy
3. OCD - Osteochondritis Dissecans
4. Pano - Panosteoitis

Knuckling over is the first condition normally seen and I will focus this paper on this particular problem. The other conditions listed a different set of problems - all usually nutritionally base and if caught early enough can be corrected with a comprehensive feeding program for Knuckling Over

Knuckling over is first noticed in the area of front leg on a puppy, or the growth plate (wrist or carpal) area. The term coined by professional breeders for this condition is knuckling over, and it describes a condition where the front end assembly of the dog, the weight bearing part of the body, is unable to support the whole body weight of the puppy, due to a lack of integrity in the muscle, tendon and ligaments. It is my opinion this condition is not genetic - it is due to uneven growth pattern between the bone and tissue/muscle of the puppy and it is cause by dietary imbalances and/or missing micro-minerals and/or minerals that are not available to the body - difficult to assimilate.

The condition of " knuckling over", can be very extreme, almost as if the legs are made of some malleable material - like rubber! Early knuckling over - under 8 weeks of age, is not a problem and very common because the large and giant breeds grow quickly during the early stages of development.

Once a puppy reaches 8 weeks of age they need to be separated from the litter during meal time, so you can keep track of the amount of food being consumed and it is during this period that we start to see the beginnings of extreme knuckling over. I have noted this problem has 4 stages in terms of degrees, and I am happy to report, if owners contact me early enough and put them on the Blackwatch Puppy Feed Program for Knuckling/Bowing - HOD Kit#5, and in some cases do wrapping and supports, we can turn them around very quickly - 2 days - 2 weeks depending on the age and length of time they have been this way.

Breeders often think growth issues are cause by too high a protein in a diet and that is not the case at all, and research shows us this is not true.

It is true that high protein diets are also high fat diets, and therefore they are high calorie diets and difficult for owners to manage the proper feeding amounts, keeping in mind puppies will want to eat much more than they actually need. But the real issue with growth problems is the relationship between the intake vs output in calories and the bio-availability of the macro and micro minerals in a food.

When you do not have this correct equation in a diet, it causes uneven growth patterns between muscles, ligaments, tendons and bones. They are all developing at different rates - the end results are severe knuckling over and this grotesque deformation can be permanent if not taken care of in the early stages. This does not only effect the carpal/wrist area, but can also the shoulder area (see below photos).

Before change of diet to Blackwatch Puppy Feed Program and wrapping with vet wrap.

Left: 11 days later she can support her own body weight. Warps are checked every 2 days.
Right: at 5 Months - her legs show no sign of developmental orthopedic disease.

Here are resources for leg wraps and supports for serious problems that can not be taken care of with normal vet wrap http://www.dogleggs.com/or www.orthovet.com

For a dog with cruciate ligament issues, it is no longer necessary to do surgery in many of these cases. With the support of a A-TraC Dynamic Brace and good diet to feed, the dog can get around very well.

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Knuckling Over

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Level 1

Puppy on the right, shows the inside leg as an example of the beginning of the early knuckling over we see at 5 - 7 weeks of age. This is not at all unusual and often corrects itself as the dog matures to 8 - 9 weeks of age, provided they are on the right diet. There will be some vacillating back and forth during the time of vaccines and ear cropping, the stress of all of this and the fast growth they go through all contribute to the problem. .

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Level 2

On Left: 8 weeks

On Right: 9 weeks after being wrapped and a change in diet, this dog is able to support his own weight.

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Level 3

8 weeks on left , then with wrapping and a change in diet and it is corrected at 9 weeks

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Level 4

On left is at 9 weeks and unable to stand and support his own weight. With a spoon splint, wrapped and change of diet you can see in 12 days this dog's leg can be straightened out. Only in extreme cases do we have to brace the whole foot, in this case the dogs toes were curled and deformed, so we needed to straighten them out so he could support his weight. He was only left in a spoon splint for 3 days then moved to a splint that allowed his foot normal movement.

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This is an image of the spoon splint that was put on behind the dog's leg in order to straighten it out. The photo on the right is 3 days later, and the dog's leg is straight. Sometimes, as in level 4 problems, we need to splint the whole foot because the dog's toes are curled under and can not support the weight of the dog. This problem can effect any large/giant breeds - it can happen to smaller breeds as well.

 

Left are examples of the bracing of this dogs legs and feet. After 12 days in a brace (checked every 2 days) and a change to Blackwatch Feed Program ,this problem is corrected to the point the animal can now support his own weight on his feet.

In order to correct level 3 and level 4 of knuckling over, it is mandatory to change the dogs diet, control the amount of food consumed and allow free exercise.

It may also be necessary to wrap the shoulder area with vetwrap, as well as the growth plate or wrist area on the dog. When the dog can't get traction due to his weak shoulder muscles, it is important to bring the legs under the dog and support with some kind of wrapping brace - images below. Have your vet help you with this so it is not too tight to obstruct breathing but will hold in the legs much like a hobble for horses...and get the dog off of slick, hard surfaces!

 

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