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What Happens During An Evaluation Appointment At My Pet’s Brace?

By: Terry Lackmeyer, My Pet’s Brace Customer Service Representative

Frequently, owners express concern about the evaluation appointment for their dog’s leg brace. Many fear that we aLeg Casting During Evaluation Appointmentre going to manipulate the dog’s leg and cause pain, or that they will not be able to remain with their pet. Neither of those thoughts are true. So, let me explain what happens during the evaluation appointment.

The first thing needed for the appointment is a written diagnosis from your vet or rehab professional telling us about your dog’s injury. Since we are not veterinarians, we need to know the exact diagnosis so that we can be sure we are making the correct leg brace for your dog’s injury.

Next, you and your dog will be taken into an exam room where you will meet with the clinician. After taking time to review the information from your vet and meeting you and your dog, the clinician will ask several questions regarding your dog’s living arrangements, time spent inside vs outside, activity level, and any other pets in the household. The clinician will discuss your dog’s injury and observe your dog walking up and down the hallway several times. The clinician may feel your dog’s leg to check for any swelling or discomfort. We may bend your dog’s leg, in a normal flexing motion, to listen for any type of clicking or popping sounds. This will not hurt the dog. If the dog shows any type of discomfort with this flexion, the clinician will stop.

Once the clinician has gathered all the information, we will explain what is going on in your dog’s leg and how and why the brace will help. You will have ample opportunity to ask any questions you may have. Sometimes, the clinician has the unfortunate task of telling the client that the brace is not the correct solution for the dog’s injury. Rest assured that if we do not feel a brace is appropriate for your pet, we will be honest and let you know that. If that occurs, there is no charge for the evaluation appointment.

After explaining your dog’s injury and how and why the brace will help and making sure you want to move forward with the brace, the clinician will make a cast of your dog’s leg. You will be with your dog the entire time, helping to keep them calm. Someone will support your dog under their belly, so they are comfortable while the clinician does the casting. The casting process takes less than 5 minutes and is completely painless and non-invasive for the dog. The toughest thing your dog will need to do is stand there, with support of course. After casting, the clinician will take measurements of your dog’s leg. If your dog is getting a hock or carpal brace, the clinician will make a tracing of your dog’s paw.

Once the cast is complete and the owner has no further questions, payment will be handled at the front desk. All braces must be paid in full before the brace goes into production.  We accept all credit cards, cash, check and Care Credit.

Our goal during the evaluation, or any of our appointments, is to provide a warm, friendly atmosphere for both the dog and owner. We want to answer all your questions and alleviate any concerns you may have regarding the brace and your dog.

Case Study: Hector – A Rescue Dog From Kuwait With Nerve Damage And An Ulcer On His Elbow

By: Amy Rosenthal, My Pet’s Brace Practitioner

The Patient: Hector, a 2-year-old desert dog mix with severe carpal hyperextension and an ulcer on his olecranon (elbow).

Case of Interest: A local rescue organization with international ties learned of and adopted Hector from Kuwait.  Hector was severely collapsed on both of his front legs and walked on his elbows.  In Kuwait, he underwent surgery to repair a fractured radius and ulna in his right front leg.  He also sustained nerve damage in his left front leg and had an open ulcer on his olecranon.  When he was brought to the States, his left front leg was in a cast for several months to support the carpus and reduce the pressure on the ulcer on his elbow.  For a long-term solution, My Pet’s Brace recommended a brace to bring Hector into a more functional standing and walking position as well as to protect his olecranon and allow the open ulcer to heal.

Diagnostic History: Hector was seen at the My Pet’s Brace facility for the casting of his leg in March 2019 for a carpal brace.  The brace would replace the splint he was in for many months, stabilize his hyperextension and aid in the healing of the ulcer on his elbow. The brace was fitted to Hector and adjustments were made to ensure a proper and comfortable fit.

The carpal brace for Hector was made with an additional foam wedge affixed to the top outside of the brace.  The brace supports Hector’s leg in a more functional position and the added wedge lifts his leg off the ground when he lays down which allows air circulation and furthered the healing for the ulcer.

Hector was informed to begin wearing the brace for two hours the first day and increase an hour each day until he wore it during his active waking hours.  Hector’s activity and exercise were limited in the beginning of the break-in period until he became comfortable and the ulcer on his elbow healed.

Follow-Ups: Hector was seen two weeks, one and half months, and four and a half months post-delivery. During each of these appointments Hector’s skin was assessed and his overall comfort with the brace was examined. Adjustments and general upkeep were made accordingly.  As of his last appointment in August 2019, the ulcer on Hector’s elbow is fully healed and he is getting stronger every day.  Hector was also adopted by his forever family and is happily living life in his new home.

Roses are Red, Violets are Blue, What Color Brace Shall I Do?

By: Terry Lackmeyer, My Pet’s Brace Customer Service Representative

While getting a leg brace for your dog is very serious, believe it or not, it does have a lighter side – choosing a brace color. For some people it is very easy, for others it requires much thought and sometimes, a family pow-pow. The good part is, we have 35 different colors and patterns from which to choose.

Some people prefer that no one notices the brace and want it to blend as nearly as possible with the dog’s coat. For those people, a solid color closely matching the dog’s coat color works well. You even can take it a step further and choose one of our patterns that looks like dog hair (but without the shedding).

Other folks feel that since the dog must wear a brace, making it fun is the way to go. For those people we have every solid color to fit the ROY G BIV mnemonic code plus white, black, brown, silver and tan.  Our most popular brace color is hot pink.

For those adventurous folks, we have various patterns that can be fused to the brace to really spice up the appearance. The hunter in the family may want the camouflage pattern; the kids, the shark or graffiti design. The star gazer may look to the cosmos or starry nights pattern; the sophisticate may lean toward the carbon fiber design; while the fashion conscience may opt for the cheetah or zebra print. Finally, for those that like abstracts the yellow/orange or blue swirl may be the way to go.

Regardless of the color or pattern chosen, rest assured that the brace will be durable and easy to maintain. Water will never harm the color or patterns and all braces are completely waterproof and easy to clean with anti-bacterial soap and water. Dog braces can even be worn in the pool or during hydrotherapy with no ill effects.

As we like to remind owners, braces work the same no matter what color or pattern is chosen. The important point is that while we enjoy providing fun color choices, our first and foremost goal is to make the most comfortable, effective, and functional brace to help your dog with their orthopedic condition and to help them to live happier lives.

When Are X-Rays Needed To Make A Dog Brace?

By: Terry Lackmeyer, My Pet’s Brace Customer Service Representative

When a dog incurs an injury, sometimes x-rays are taken to get the “inside” scoop on exactly what’s going on with that injury.  Does that mean that we need to see x-rays to make a leg brace for your dog? Well, it depends on the injury.

If your dog has a Cranial Cruciate Ligament (CCL/ACL) injury, the injured ligament will not show up on x-rays. However, your vet may take X-rays of the knee because they want to rule out other possibilities. They may be looking to see if your dog has arthritis, a tumor or cancer. Once they see that there is nothing else lurking in your dog’s knee and they have gotten a positive result on what is called a “drawer test” on your dog’s leg, they can feel comfortable diagnosing your dog with a CCL injury.

Braces can often be used to help dogs that suffer from arthritis. These can be stifle, carpal, hock, or elbow braces since arthritis can occur in any joint. In that case, we would want to see X-rays to determine the location of the arthritis and if a brace would be an appropriate solution.

Carpal, hock, and elbow braces for dogs can be used for a variety of issues – everything from hyperextension to elbow dysplasia and many conditions in between. If we feel X-rays are needed, we will request that x-rays be provided to us before or at the time of the initial consultation.

Many times, owners contact us because their dog has been diagnosed with osteosarcoma, a type of bone cancer than often leads to spontaneous fractures. Then x-rays are very important to determine the exact location and involvement of the cancer. Frequently, we can provide a brace which is created with a front and back piece so the brace acts like a splint to help prevent or prolong the possibility of a fracture yet can be easily removed to care for the leg.

Rest assured, if we feel x-rays are required, we will request that they be provided so that we can be sure to make the best and most appropriate brace for your dog’s injury.

 

To Shave Or Not To Shave (The Dog’s Leg)

By: Terry Lackmeyer, My Pet’s Brace Customer Service Representative

Owners frequently ask us if their dog’s leg needs to be shaved for the casting process or to wear a brace/prosthesis. The good news is that no, you do not, and there are several good reasons for that.

The first reason is that we are in favor of anything that reduces stress for the dog. For many dogs, shaving the leg is stressful and upsetting and if there is any way we can avoid stressing our patients, we will. The skin on the leg can also get irritated from shaving and we don’t want to do anything that causes more irritation to an already injured leg.

The second reason is that we have learned how to work with hairy dogs, and the hair does not get in the way. When casting a dog’s leg, the leg is first covered with a stockinette (a thin sock-like material). This compresses the hair on the leg. For those hairier dogs, such as Golden Retrievers or Newfoundlands, as much of the hair as possible is gathered inside the stockinette. This helps the casting process by keeping most of the excess hair out of the way as the cast is taken. The fiberglass tape is wrapped snuggly around the leg, thereby compressing the hair even more, helping to ensure a good cast is taken and, subsequently, a well-fitting brace is made.

Finally, when the dog is wearing the brace that extra hair under the brace acts as a nice protective cover. This helps to reduce possible irritation as the hair provides additional cushioning.

Sometimes owners will comment that all that extra hair gets caught in the Velcro straps and makes putting the brace on more difficult. In that case, owners may choose to use scissors to trim away some of the excess hair. That’s perfectly fine and will not affect the fit of the brace.

Our ultimate goal is to make the casting and bracing process as pleasant and stress free as possible for not only the patient, but also the owner. If an owner wishes to trim excess hair to make putting the brace on easier, that’s fine, but from our point-of-view the dog’s hair is a benefit and shaving the leg is not needed.

Case Study: Nya – a Shepherd mix with a Carpal Brace Post Fixator Surgery

By: Clayton Blunk, My Pet’s Brace Practitioner

The Patient: Nya, a five-year-old, 50-pound, Shepherd mix that was hit by a car.

Case of Interest: Over 80% of our business is providing stifle braces for Cranial Cruciate Ligament injuries. However, we also fabricate carpal, hock and elbow braces for multiple etiologies. In special cases, we are brought onto a case in collaboration with orthopedic specialists for a non-standard brace.

Nya was hit by a car in mid-2018. After being stabilized by an emergency department in Maryland, the initial prognosis was that Nya would not be able to save both of her forelimbs. She was transferred to the University of Pennsylvania to attempt to save her legs. My Pet’s Brace become involved in the case at the end of December 2018 to make a special carpal support brace.

Diagnostic History: In mid 2018, Nya was hit by a car. Eventually, after multiple procedures, her right forelimb needed to be placed in an external fixator. In December, the fixator was removed. Diagnostic imaging after the fixator was removed showed promising stability, but there were still considerable open wounds that needed managing and protecting. While Nya was still sedated, her condition was evaluated and her medical team at University of Pennsylvania determined that she would benefit from a carpal brace.

Nya presented to My Pet’s Brace limping and in a splint.  We made a cast of Nya’s forelimb from the paw to just distal to the olecranon. This cast was then used to create a custom-made, non-jointed carpal brace. This brace was made with a closed-cell foam interior and a hard-medical grade plastic exterior. Special consideration was given to the bony areas where the pins from the fixator were located. It was important to unload those areas to allow them to heal. Additionally, Nya did not have a normal weight-bearing surface because of the position her limb was fixed. Nya’s brace was designed to have extra padding to prevent excessive pressure on her toes as well as widen the base of support for her paw.

Follow-Ups: Nya was seen approximately 1 month and 3 ½ months post-delivery. At each of the follow-up appointments her condition was evaluated and straps were replaced as necessary. At Nya’s first recheck, her swelling had reduced significantly so padding was added to the inside of the device to tighten the fit of the brace. The owners reported that she was able to ambulate well and the brace was helping effectively manage her wounds because of the ease of removing the brace and cleaning the limb. By early April 2019, her wounds had entirely healed and her team at UPenn cleared her for a return to normal activity with the brace.  Her owners report she is able to keep up with their new puppy. We will continue to follow up with Nya’s progress as she continues to recover from such a traumatic event. She is a happy dog who will be able to enjoy life as a normal dog for years to come.

Case Study: Philomena – a Pug with a Brachial Plexus Injury

By: Amy Rosenthal, My Pet’s Brace Practitioner

The Patient: Philomena, a 15 pound 1-year-old Pug with a spinal injury and a brachial plexus nerve injury resulting in a paw contracture and partial paralysis of her front left leg.

Case of Interest: The most successful clinical outcome for a pet with a custom brace is the result of a team effort between the pet family, veterinarian, rehab specialist and the My Pet’s Brace practitioners.  With everyone working together, Philomena’s condition continues to improve to this day.  Philomena originally visited our Morgantown, PA facility for a carpal brace at the referral of her physical therapist.  As her range of motion improved, a second carpal brace was fabricated.  Philomena was in need of a third brace, but had moved away from our main facility.  Luckily, she was within driving distance of our new patient care clinic in Knoxville, Tennessee where she was cast and fit with her third carpal brace.

Diagnostic History: In February of 2017, Philomena jumped from a couch and landed heavily on the floor. The impact resulted in a brachial plexus nerve injury which caused partial paralysis of her left side and contracture of the left front paw. The contracture of the paw caused her to drag her leg and walk on the top of her paw, resulting in abrasions. She attended hydro and physical therapy sessions and was regaining function in her left side. Her physical therapist referred Philomena to My Pet’s Brace for a brace to protect the left paw and carpal joint.

Philomena presented to our facility in July of 2017 with a contracted left paw. She had good mobility in the remaining limbs and was alert and eager to move. It was determined that a non-jointed carpal brace would be beneficial for Philomena. The brace would protect the top of the paw from abrasions and would halt any further collapse of the carpal joint. A cast was taken of her front left leg from the elbow down at an angle that was comfortable for Philomena. A custom brace was then created using the cast. The brace was made using medical grade plastic and straps with pads to hold the brace securely on her leg. The brace was also equipped with a rubberized sole to aid in walking and movement. Philomena returned a week later to be fit with the brace. Appropriate adjustments were made to ensure an accurate and comfortable fit.

Follow-Ups: Philomena returned in November of 2017 to be re-cast for a second brace.  Through therapy she was achieving greater flexibility in her paw and she needed a new brace with a more accurate angle. She returned a week later to be fit with her new brace.

Due to her progress with physical therapy, in June of 2018 it was determined that a third brace would be best for her continued improvement. Philomena and her family had relocated to Georgia during this time.  Happily, our Knoxville, Tennessee location was convenient for them to visit for appointments.  The practitioners at our Morgantown and Knoxville facilities discussed Philomena’s case and shared notes prior to the casting and fabrication of her third brace.

Philomena continues to go to physical therapy, hydrotherapy, and acupuncture.  We look forward to seeing her progress as her condition continues to improve with the help of her brace and her entire team.

Follow Philomena on Instagram, Facebook and YouTube @PhilomenathePug!
Video courtesy of Philomena’s humans.