Recovering- a look into an elbow break
by Maria K. Duthie c.e.f.m.p.
My five year old Australian shepherd fell fifteen feet out of the hay loft down to the cement floor. He hit the floor and screamed and I ran to him. He was given arnica montana within a few seconds of his accident. He was iced head to toe within fifteen minutes and we continued the ice off and on for the next five hours until he was splinted. The initial x-rays showed a break in the Ulna at the elbow joint. The original Vet was unable to splint it due to the location of the break. If his elbow was splinted incorrectly he could loose mobility. The only option for a break in this area is surgery. We drove Flip down to the specialist who of course since it was a Friday after five. was gone. The tech splinted the leg. Throughout this time he was iced and given arnica at regular intervals. He was anesthetized for the splinting and came to me very groggy. They told me to keep a leash on him. He never walked with this splint on because he was in far too much pain. Something I did not expect from their instructions. He was on a fentnal patch and tramidal and still screamed each time he tried to move or we tried to pick him up to take him out. He was not scheduled for surgery until Tuesday the 22. The pain he was in was inhumane and I could not wait as they had wanted me to. I called Pittsburg veterinary surgery and they were able to do the surgery on the 21 and I was able to talk with them to find out what they were planning on doing. Flip is an active dog as well as an agility and herding dog so he needed to be given the best chance to fully recover. Throughout the weekend He was iced six times a day over the splint as well as massage. I used effleurage on his splinted leg and all over his body this kept the circulation going as well as helped decrease the swelling. Thumb gliding on his back helped release the tenderness in his back both due to the fall and due to the constant tension from pain. Compressions on his hind leg helped to maintain muscle tone and to increase the circulation. I worked points on his bladder meridian with acupressure as well as his ting point on his toes. He could not move so I also tried to play some games with him to keep him mentally stimulated and to ward off depression. I had him touch my hand and take his dumbbell. He also took the soft ball and gave it too me. His back and jaw were also sore from the fall so I had to make sure he was comfortable as he used his mouth. I also started him on boswellia which is an herbal anti - inflammatory to keep the swelling down. In addition he muscle tested for wobenzyme without food again for the inflammation. He never spent a minute alone the entire weekend. I massaged and iced in a constant rotation. The ice, effleurage, compressions, and boswellia I feel were very important that long weekend.
Monday the 22 he was placed in the car and driven from Cleveland to Pittsburg for his surgery. Dr. Pardo handled his case and was very attentive and explained exactly what he was going to do. One thing he did was x-ray the thorax which I should have requested on Friday after the accident. Flip could have had other things wrong that we did not know about. I left him at 10 am. and I received the call at 1 p.m. that he was out of surgery. I visited him at 3:30 that afternoon to work on him. Again effleurage was the main thing I did at this point. I also used zero energy balancing and reiki. Thumb gliding helped both his neck and back. I was able to spend an hour on him there in recovery. At that time they showed me the x-rays both before and after to show me the plate 8 screws and the wire they used to stabilize the bone. Flip went home with me that night.
The next two weeks he was only allowed out to go to the bathroom then back in. He left with a vet wrap bandage on his leg on Monday which I was able to remove on Thursday. While bandaged compressions worked well to get the blood moving. I was now able to get in and use v spread and raking on his quads and hamstrings and his good arm. I did not do this on his bad shoulder because the triceps and biceps bend and straighten the elbow and I wanted to give the bone a few days to settle. The compressions however really helped to maintain blood flow and help to get circulation going through the leg. Effleurages on the leg done over the bandage was also important. The ice continued four times a day and I was able to begin range of motion on his other three legs. He was in a crate for four days then into a small x pen. When he was out being iced and massaged he was on leash because now he was able to move. I could not do much to mentally stimulate him other then small hand touches because he was too ready to try other things. The boswellia and wobenzyme continued. He was also on traidol for another week. Adiquine injections were started on Tuesday the 22. They continued ever four day for five weeks then every two weeks for one month then once a month. He also began glucosamine and chondrotine.
On Thursday the 24 I took the bandage off. His leg looked great. At this time I started range of motion exercises with him. First folding the arm up as far as it could go then extending the arm forward towards his ear then backwards towards his back legs. I would then move the leg as if he was walking. His range of motion began at about 75 % then increased to 100% within four days. He was tender to the touch so I never held the elbow. Ice followed each range of motion session. He had these four times a day.
His incision looked great also but I still used a zinc compound on it for two weeks then changed to colndulla ointment after the staples were out. This kept the incision line soft and pliable. I worked the line with massage techniques that freed up scare tissue such as chucking. I would move along the line moving one finger one way and the one on the other side the other way. This allowed the skin to move to decrease the chance of adhesion.
February fifth he went and got his staples out. After this visit he was allowed two ten minute walks a day which helped him stay quiet. He was in an x pen at this point with a top and still small so he could not run in there. Range of motion four times a day still and after three weeks it went to three times a day. I did this after his ten minute walks and after his late night trip out. Following each session he was iced for twenty minutes. I purchased an elbow icer from canine icers.com to help with this. Now I was able to give him a full massage each day with passive range of motion on all four legs. Each foot and toe was turned in each direction and stretched. Twenty compressions and twenty v spread and raking combinations were done on each leg each day. Both the boswellia and wobenzyme continued. It was harder and harder to keep him quiet. He was allowed to walk around our living room which is very small while I was right there.
March fifth He went back and was re x-rayed and declared healed with no arthritis: full range of motion and no stiffness in the joint. Two more weeks not jumping off anything and still on leash so he does not run. The x pen is full size and he is out while we are home. Longer leash walks about a half hour twice a day. He is still iced three times a day and range of motion three times a day. Full massage continues on a daily basis. Now is when the real work begins. He needs to get back to full strength before he can go on to train for his performance events. He walks sound 98% of the time and that had begun about four weeks after the break.
View x-rays here. Jan. 20, 2008 Jan. 21, 2008 Healed March 5, 2008
I feel the range of motion exercises have made his recovery go easy. Also each technique that increases the circulation helps in the healing process. He will be leash walked for four weeks now and begin exercises like picking up the good leg and have him stand on the bad one. Thanks to the massage he has no compensation issues. He used to get a spasm behind the bad shoulder but with digital circles each day this was released and has not returned. His recovery plan is to continue to lengthen the leash walks for a month then allow him off leash. Once he is playing ball and Frisbee with out a hitch and doing all the dog things he likes to do he will be allowed to begin training agility again. He was lucky he broke a non weight baring bone and it healed 100%. The important thing is he is alive and will be able to run and play again. Anything extra is a plus. It is a constant effort on both our parts to continue to strengthen and maintain full range of motion. If you have any questions or comments please contact me.