What You Should Know About Dog Knuckling

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One day, you suddenly notice your dog standing or walking on top of his feet instead of using his paws. Or you're taking your dog for a morning stroll, and you see that the top of your dog's paw drags along the ground as he's walking. Either situation is an understandable cause for alarm. These behaviors are associated with knuckling and can indicate various conditions affecting your pet's health.

What is Dog Knuckling?

Dog knuckling is a neurological condition where a dog's paw or paws bend under, causing them to walk on the top of its paw or knuckles rather than its pads. It is a sign of a problem with the dog's nervous system and can be caused by various conditions, including injury, disease, or spinal cord degeneration.

The condition is usually seen in the hind legs but can also occur in the front legs. Sometimes, dog knuckling can be treated with medication, physical therapy, or surgery. However, the condition's underlying cause must be diagnosed and addressed to prevent further damage to the dog's nervous system.

Causes of Dog Knuckling

It's important to note that dog knuckling is a symptom and not a specific disease, so identifying the underlying cause of the condition requires a thorough examination by a veterinarian.

Neurological Issues
  • Spinal stroke (Fibrocartilaginous embolism or FCE) occurs when a cartilaginous disc that acts as a shock absorber near the vertebrae ruptures. Additional problems arise when a small piece of a ruptured disc enters the bloodstream and obstructs one of the small vessels that supply blood to a specific spinal cord area. FCE is most common in young giant and large breeds of dogs but has been known to occur in smaller breeds like the Sheltie and Schnauzer. An afflicted dog may cry out during activity and become immediately weak or paralyzed.
  • Intervertebral disc disease (IVDD) results from disc issues. If a disc suddenly ruptures into the spinal canal, the disc will degenerate and begin to bulge. IVDD puts pressure on the spinal cord and causes a dog to become weak or paralyzed in the hind limbs. Dogs may exhibit signs of pain in their neck and back or drag their feet. Long-backed breeds such as Dachshunds are predisposed to this particular condition.
  • Degenerative myelopathy is a chronic disease of the spinal cord causing paralysis. The initial symptoms are similar to arthritis and hip dysplasia, but as the disease progresses, it will cause the dog to have a weak, wobbly gait and knuckle over on one or both hind legs. This progressive condition results in the dog being unable to walk and control its bowels and bladder. This disease primarily affects middle-aged and older dogs and usually has a poor prognosis, as there is no known cure.
  • Wobbler Syndrome is a condition that causes the affected dog to have a wobbly gait. Dogs with this syndrome will have spinal cord compression in their neck caused by a narrow spinal canal, intervertebral disc herniation, or a narrowed spinal canal due to changes in the surrounding bone. Great Danes and Dobermans seem susceptible to developing this syndrome.
Orthopedic Problems

While most underlying causes of knuckling are due to nervous system issues, an orthopedic condition known as carpal flexural deformity affects the carpus or wrist. This condition is typically caused by genetic predisposition and nutritional factors and usually occurs in puppies.

Carpal Flexural Deformity

Carpal flexural deformity affects large and giant breed puppies younger than four months. The puppy may have hyperextension, hyperflexion, or a looseness of the carpus (wrist). The carpus can also be bowed inward or outward, causing the carpus to appear knuckled. Fortunately, most affected puppies improve within one to three weeks of a diagnosis. A diet change and splint support help during the recovery period.

Trauma or Injury

Your dog may be knuckling under due to pain or an injury to the paw. Check your dog's paws for any sharp objects embedded or an injury. Burns from hot pavement or sand can also cause an injury to the paw pads. Other potential reasons could be insect bites or a broken toe or nail.

Lack of Muscle Tone

Knuckling can occur due to a lack of muscle tone in puppies or dogs with nutritional issues or with older dogs that are frail and lack muscle tone. Older dogs with arthritis may find it uncomfortable to walk and start to knuckle to relieve joint pain.


Overweight dogs with poor muscle tone may also experience knuckling due to the instability caused by carrying excessive weight. Obesity is something to avoid if possible, as it creates health issues and makes existing health issues difficult to manage.

What Are the Symptoms?

One of the most apparent symptoms of this condition is when your dog knuckles its paws over. Knuckling can occur with the front or rear feet. Another sign is difficulty walking, where your dog exhibits an unsteady or uneven gait or wobbling. Dragging of the paws when walking is another common sign of the condition. While standing, your dog may lose balance and place the foot down abnormally.

How Can It Be Treated?

There are treatments available for this condition. To determine an effective course of treatment, it's vital to identify the exact cause of the knuckling. Depending on the cause and severity, some dogs may recover over a period of time, while other cases may remain permanently impaired.

Diagnostic Tests

Your veterinarian will conduct a series of diagnostic tests to determine the underlying cause of the knuckling. Radiographs are helpful, but a definitive diagnosis may require an MRI. Achieving a conclusive opinion may involve a referral to a veterinary neurologist.

Other tests may involve injecting dye around the spinal cord and then taking a radiograph or using an MRI or CT to find the areas of compression in the cases of IVDD. There is no definitive test with degenerative myelopathy, although blood testing will help determine the presence of a mutated gene believed to contribute to the condition.

Treatment Options

The course of treatment will depend on the cause of the knuckling. When starting treatment plans for any condition, it's always best to consult your veterinarian.

  • If your dog is knuckling due to an injury or a sore paw, it will be easily treated by cleaning, bandaging, and treating the affected area. Ideally, your dog should have restricted activity to allow the area to heal.
  • NSAID (Non-steroidal anti-inflammatory drugs) can be used with most treatment methods to manage pain.
  • Laser therapy is an increasingly popular option that offers pain relief, improved healing, and decreased swelling and inflammation.
  • If your dog struggles with an unsteady gait, toe grips can help your dog regain traction while walking. Toe grips will aid your dog's stability and protect against repeated nail trauma from dragging.
  • Using mobility aids such as a mobility harness will help get your dog up safely and assist with moving them short distances. Doggy wheelchairs are another viable option to help your dog get moving.
  • Customized foot braces can help provide support underneath the foot to help with dogs knuckling in their front or rear paws.
  • Physical therapy is beneficial for offering low-impact and gentle exercises. You can contact a rehab professional or do the exercises at home.
  • Alternative therapies such as massage, acupuncture, and acupressure can prove beneficial.
  • Surgery may be required in ruptured discs to take pressure off the spinal cord. If a dog is experiencing symptoms of paralysis, back or neck surgery is usually the best solution for a successful recovery. Even with surgery, in some cases, a certain degree of weakness or paralysis will remain.
  • With puppies, dietary correction may be all that's needed in cases of carpal flexural deformity.

You can take measures to help prevent this condition from occurring. It is essential to monitor your dog's activity and exercise. Dogs predisposed to this condition shouldn't be allowed to run and jump excessively. Managing your dog's weight is essential since obesity will only increase the health risks.

Invest in protective dog boots if your dog is exposed to hot surfaces or ice and salt in the winter. If your dog won't tolerate boots, foot wax is another option. Keep any long hair in the paw area trimmed.

OrthoPets: Supporting You and Your Pet Every Step of the Way!

Ensuring your pet's quality of life is part of being a responsible pet owner. Choosing a reputable company when selecting an orthotic or prosthetic is essential to assist your pet's mobility goals.

If you need a custom brace to help manage a dog with knuckling, OrthoPets provides a superior product and cares about your pet. Our friendly and knowledgeable staff can fit your pet into the appropriate custom brace. Contact us today, and get your dog moving in the right direction.

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