A puppy born with his front paws facing up instead of down and unable to walk is recovering after surgery at Oklahoma State University’s Center for Veterinary Health Sciences.<\/p>\n
Dr. Erik Clary,\u00a0DVM, Ph.D., DACVS, associate professor of veterinary clinical sciences, is delighted with the progress of the 10-week-old dog named Milo. The 8-pound puppy had elbow surgery Jan. 9 in Stillwater.<\/p>\n
Clary says Milo, a part-beagle and part-coon-hound mix, suffered from congenital elbow lunation, or dislocation, in both elbows. \u201cThis disorder is very uncommon,\u201d explains Clary. \u201cIn 27 years of service as a practicing small animal surgeon in referral practice, I have only seen three cases, Milo included. Many veterinarians will go their whole careers and never see one case. Referral surgeons are often sent the odd and unusual cases, and so for me to go 27 years \u2014 beginning as an intern at University of Georgia, then a resident at NC State, and then 23 years in practice \u2014 seeing only 3 cases, that tells you how uncommon it is.”<\/p>\n
The day before Milo\u2019s surgery, Clary and his team performed a CT exam, obtaining 3-D reconstructions to assess the bony anatomy. \u201cSome dogs with this condition can also have bony deformities that can complicate the situation,\u201d says Clary. \u201cFortunately, Milo’s bones were pretty straight.\u201d<\/p>\n
On the day of surgery, Milo was anesthetized, prepped and taken to the operating room. \u201cFor each elbow, we had to open the joint \u2014 an arthrotomy procedure \u2014 and realign the bones of the elbow,\u201d describes Clary. \u201cAnd in the process, that \u2018untwisted\u2019 that lower limb that had been rotated almost 180 degrees due to the elbow laxity.\u201d<\/p>\n
Clary then placed a pin across the joint in order to help maintain the bony alignment. \u201cWe have a C-arm fluoroscope machine in the operating room that takes a type of radiograph \u2014 this is what we used to insert each pin to a precise depth,” explains Clary. “Milo’s body will now lay down internal scar tissue alongside the joint and his bones will grow further in proper relation to one another.\u201d<\/p>\n
To help maintain the stability and minimize the stress on the pins, the team applied a front body splint before waking Milo up from anesthesia. \u201cBecause he is a rapidly growing puppy, we have had to change the bandage\/splint every 7 days,\u201d explains Clary. \u201cThis coming week we will remove the pins. If Milo’s body has done its job and the elbows are stable, we will begin the work of intensive rehabilitation therapy to restore range of motion in the joints and to help Milo learn how to walk.\u201d<\/p>\n
Jennie Hays, of the nonprofit Oliver and Friends Farm Sanctuary, is caring for Milo post-surgery. \u201cTaking care of a puppy that is largely immobilized by the splint, and keeping the bandage clean and dry are no small tasks,\u201d says Clary. \u201cJennie has done a great job.\u201d<\/p>\n
Success is not guaranteed, says Clary, and \u201cin the cases drawn from the literature, we can expect odds of a little better than 50:50 that Milo’s elbows will stay in place \u2014 that is, not dislocate. If dislocation happens, generally it will be in the first 3 weeks after the pins are removed. If the elbow remain stable, with good rehab therapy, Milo should eventually be able to ambulate as most dogs do.\u201d<\/p>\n
The widespread attention the surgery has received has surprised Clary.<\/p>\n
\u201cWhen I asked our CVHS media specialist to help me document Milo’s case, my only thought was an opportunity to help educate CVHS students, referring veterinarians, breeders, and the general public within our region,\u201d he says. \u201cI never imagined the level of publicity the story has now attained \u2014 it has gone national, including AP News, and even international. Still, my chief objective in facilitating the telling of this story is to help colleagues and others know that on the rare occasion, they should come to meet a puppy like Milo with the congenital elbow luxation disorder, they will know that the situation is not necessarily hopeless.\u201d<\/p>\n