OrthoPets functions as a virtual clinic and fabrication lab enabling us to virtually work with veterinarians and their patients all around the world. In some unique circumstances we do get to meet our clients and patients in person! In December we were able to meet a sweet Golden Retriever named Casey and his mom, Francie. Casey was a rescue through Golden Retriever Rescue of the Rockies (GRRR) and received amazing veterinary assessments and care. While at one of their galas, his adopted mom received a free voucher for an appointment/assessment with OrthoPets. Casey is 4 years old and was adopted and evaluated at GRRR revealing a mostly unknown trauma/developmental history. It is likely that he was born with a portion of his limb missing, and his owners were worried about him developing compensatory issues to his spine and other limbs if he were to grow up with a partial limb. Casey is a very active boy and lives with 3 other canine siblings resulting in him having high energy "jobs" to do at home.
When we met Casey, we were provided with radiographs of the affected limb to further assess what was remaining. Martin Kaufmann, our owner, and an OrthoPets case manager took on his in-house appointment and came up with a great solution for Casey's mobility needs. One of the perks of working with the OrthoPets team is that our case managers are all certified veterinary technicians and are trained by our owner/founder Martin as well Dr. Felix Duerr (our sports med and surgical consult at Colorado State University) to assess candidacy for each case based on x-rays as well as to help determine if any sort of revision surgery may be needed for that patient.
When OrthoPets assesses each prosthetic candidate, there are a few factors which dictate the type of device needed:
Which anatomical joints are present and functional?
What is the length of the residual limb segment distal to the last anatomical joint?
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 minimum requirement for a prosthesis to gain suspension and limb purchase is at least 40-50% of the radius/ulna. For a prosthesis to be functional, the patient needs to have at least a functional elbow joint with active control over elbow flexion and extension to control the ground reaction forces acting against the socket. Distal limb amputations will assist in improved device suspension and increased proprioceptive feedback for the patient.
Casey presented with a great level of limb remaining for suspension of a prosthesis and had minimal discomfort of the limb when palpated. He did palpate with a tight FCU and restricted end extension ROM, which should not cause any discomfort in the prosthesis but was something to note on his exam. He had a very prominent area near what was likely a residual dewclaw. It was also noted that internal rotation of the manus was present. The level of his likely traumatic amputation as a puppy was at the mid metacarpal region. Due to the length of limb distal to the carpus, OrthoPets was not able to provide a hinged prosthesis, but were able to provide a non-hinged below carpus prosthesis with a cranial clamshell (shell closure) and removable foam liner for comfort and ease of replacement in the future.
Casey presented to OrthoPets for his fitting once
his device was ready. A prosthesis will take 7-10 business days to make once OrthoPets has received payment as well as everything needed to process the case. Casey did an excellent job at his fitting and was quite comfortable right away. Martin and the case manager spent a significant amount of time with Casey and his owner at the fitting appointment. Casey started off not wanting to place the limb as consistently as desired, which can be expected at an initial fitting appointment. We worked with him on simple weight shifting and balance exercises, as well as slow and controlled leash walks to encourage proper limb placement at each step. Casey is a very smart patient and by the end of the appointment he was placing his device well about 75% of the time and had even practiced going up and down stairs as well as walking on different types of terrain.
Casey will continue to work on specific rehabilitation exercises at home with his owner to ensure that he continues to do well. His owner reports he is a crazy dog and does laps around the yard in his prosthesis and has no trouble at all with getting around. We cannot wait to keep up with Casey's progress over the next few months!