A Leg Saved!

I was sitting at home on a Sunday when the call came for an emergency.  A large dog had slipped and cried out, coming up lame on a hind leg.  My mind immediately went to a possible ACL tear, a common knee injury to both football players and larger dogs. I arrived to find a goofy eight month old pitbull, blue merle in color, named Kush.  He had been turning a corner in the house quickly and slid on the tile.  I began my exam, but was very surprised at what I found.  Despite what I had thought previously, I could easily tell that this dog had actually fractured his leg.  He broke his right tibia and fibula, the bones between the knee and the ankle.

After some discussion with the owner I decided to send her to the mainland the next day for x-ray and to discuss surgery.  I am not able to perform any pinning or plating orthopaedic procedures here.  I wrapped the leg with a splint to provide stabilization, gave pain control, and sent him home.  The next morning they were off to Belize City on the ferry, a ninety minute ride.  Once there, Kush had an x-ray.  Indeed the leg was broken, about mid way down the lower leg.

First X-Ray (he is still wearing the splint, which you can see)

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Unfortunately, after talking to both the owner and myself, the vet there decided there was nothing surgical that he felt comfortable doing or had the ability to do.  He left the dog splinted.  I knew age was on his side, the dog was still growing and so healing would be easier.  I cringed though at having this dog in a bandage splint for weeks or months.  I had already had numerous failures with bandage care at home.  Keeping it clean and dry and keeping the dog confined, I knew, would be a great challenge.

Kush came for a recheck with me a couple of weeks after his initial visit.  He had been very well confined but his foot was wet and upon removing the bandage the skin was sloughing and smelled terrible.  I had no choice but to clean and dry it and put a new bandage back on.  Leaving it off would not allow his leg to heal.  We started him on antibiotics.  From this moment forward his family was extra diligent about bandage care.  If there was even a hint of an issue they appeared at Saga for help.  He became one of my favorite patients and I looked forward to his visits.  We would often sedate him to make changes easier to not disrupt the healing of his leg.  Around week four we took him to the local human clinic for a follow-up x-ray.  There was healing taking place with new bone forming, but not enough to set him free from his splint.

Kush Getting an X-Ray

X-Ray After 1 Month

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With his skin issues resolved and things going well we soldiered on.  Another two weeks went by with a bandage change in the middle.  I started making up names for him, Kushy, Sir Kushington, he always made us laugh.  He returned for another x-ray after 6.5 weeks in his splint (a tremendous feat) and the leg looked good.  I furrowed my brow with confusion at first, wondering what all these little white squiggly lines were on the leg, I then realized with a laugh that I had used some donated gauze to pad the top, and it contained radio-opaque threads, the kind that show up on x-ray if a surgeon forgets a gauze inside you!

X-Ray After 6.5 Weeks

With some trepidation, I removed the splint completely.  He had some mild skin irritation and so we left the E-collar (cone head) on so he could not lick.  I sent him home for a SLOW return to activity.

Recently Kush came back for his recheck.  No longer wearing his E-collar, his skin looked perfect.  He was walking normally on both hind legs.  I could feel the thickened area of bone where he has healed.  He still occasionally holds the leg up when he runs, but he also had his leg stuck in one position for an extended period of time.  I am hopeful that with continued exercise and time he will have total normal function of his leg.  Success!

This happy ending was only possible because of Kush’s owners.  They were very dedicated and had near perfect compliance to my orders.  They are the reason that we were able to save his leg.  I couldn’t have been happier.  He even gave me a smile and a big kiss.

Kush Says Thanks and Goodbye

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