Gibson is a 5-year-old MC Border Collie that lives in Mexico. His veterinarian is Dr. Gabriel Ramirez who has a long working relationship with OrthoPets. Dr. Ramirez frequently sees cases that have had complications elsewhere and is known to “think outside of the box” with the goal to his patients to gain their mobility back as quickly as possible. In Gibson’s case, he had a pancarpal arthrodesis. Unfortunately, the post-operative bandage was placed too tightly and caused tissue necrosis. The medical team tried to save the limb but eventually the “only” established option for him was a full-limb amputation. However, since the affected area was distal on the limb, the owner elected a sub-total amputation and prosthetic.
OrthoPets is currently gathering retrospective and prospective data on canine prosthetics, however, based on our current experience a few things are important when considering a prosthetic device: Prosthetic candidates should be amenable to handling of the residual limb and a long enough limb to allow appropriate suspension of the device and proprioception to properly use the device in a functional manner is necessary.
The combination of these two factors will translate into the functionality of the device and ultimately serve as a predictor for the success of the case. The total length of residuum is currently unknown, and it varies depending on the anatomy of the remaining limb. For example, we have some cases that show appropriate suspension with a mid-radius amputation while others don’t have prominent enough humeral epicondyles to allow successful suspension. In general, the more distal the better the chances to have a successful outcome. As such, Gibson is a perfect case for this treatment.
Regarding the surgical approach to a sub-total amputation with the goal of utilizing a prosthesis, it is important to consider the following:
- Skin suture line location to avoid scar tissue formation on the weight bearing surface of the limb
- Remaining soft tissue placement to encourage comfortable weight bearing
- Identification of nerves to avoid placement over the residuum
Gibson’s amputation was performed so that the accessory carpal bone remained which created a bulbous distal end aiding with the suspension. The device was fabricated with a removable liner for replacements to be sent as needed rather than requiring the device to be sent to us. A traditional style prosthesis has a “fixed” liner that is connected to the shell requiring the entire device and additional steps to replace or change the liner. The removable liner approach allows us to replace, duplicate and adjust the foam liner without needing the entire device.
Gibson was fit with his prosthesis and immediately took very well to it! So far, Gibson’s device has not needed any adjustments aside from tread replacement which can easily be done by his owner. The entire team at OrthoPets as well as his medical team was pleased with the fit of the device and how quickly Gibson adapted to his old activities such as playing with a Frisbee. Gibson will need regular rechecks to ensure that the device is not only fitting well but that the device is still providing appropriate function to his affected limb.
For additional information: Colorado State University is conducting an ongoing study evaluating partial amputation in dogs. Read more here.