This week I had the pleasure of going for a walk with Uvetta, a white and orange-speckled two-year-old female English pointer.
Three months ago, Uvetta was involved in a road traffic accident on Manoel Island. She had just been left off the leash and was bounding about with joy when a car came around the bend, startling her in the process. Frightened, she ran out in front of the car and got run over. In the moment of confusion she fell in the sea. At the clinic, it was difficult to tell who was more in shock – Uvetta, or her owners. Both were cold and wet, and after warming them up as best as I could, I got to work on Uvetta.
I was dismayed at the extent of injury to her left leg. The thin layer of flesh that normally covers the lower part of the leg had been ripped apart, entirely exposing the bone beneath. It was therefore clear to see that not only was Uvetta’s hock joint badly dislocated, the joint ligaments were also completely torn.
The hock joint is the part of the hind leg of the dog that equates to the ankle joint in humans. The origin of the term comes from the old English name for ‘heel’. The hock comprises a complex structure of bones and joints that connect the upper part of the hind leg to the lower part which, in turn, connects to the paw. The hock joint is also supported by an important set of ligaments on the inside and side of the joint that aid the dog to walk.
Unfortunately, injuries to the hock joints and ligaments are quite common in dogs. Traumatic injury such as getting the lower leg trapped while running, and road traffic accidents as happened with Uvetta, are typical of such accidents.
Most injuries tend to be soft tissue injuries to the ligaments and joint capsule. But sometimes, injuries to the hock joint are far more serious, ranging from hairline fractures of the small bones of the hock, to hock dislocation, broken bones and open wounds. Having an open wound complicates the case because infection becomes more likely and healing that much slower, while complex fractures accompanied by damaged ligaments can result in instability of the joint.
The hock joint is the part of the hind leg of the dog that equates to the ankle joint in humans
Signs of hock injuries vary depending upon the severity of the case. With slight injuries to the ligaments, the dog may limp and there may be swelling and pain. With small fractures it might still walk, and with more serious fractures or torn ligaments the dog may be reluctant to bear weight on its injured leg and hold up its leg while walking.
With major trauma, the dog is unlikely to get up and walk. In all cases it is best that your pet is taken to your veterinary surgeon to check out the injury and advise on the treatment or next step necessary.
The vet will start by examining your pet’s vital signs to establish if there are any life-threatening injuries before attending to the hock injury. With the patient stable, they will then start working on the injured hock. Treatment depends upon the case.
As a start, your vet is likely to take X-rays of the injury since they help evaluate the extent of the trauma. Your vet may also opt to take stress X-rays that help to see what happens to the hock when it is moved.
Broken bones will then be manoeuvred back into position and held in place with splints. This serves to stabilise the injury. Your pet will certainly be under sedation and will suffer no pain. Serious breaks may require surgery and, depending upon the nature of the fracture, various stabilising mechanisms such as internal metal pins, plates, wiring or external skeletal fixations may be required. Sometimes, the extent of damage is so severe that specialist orthopaedic treatment becomes essential. Your vet will guide you in this respect.
Damaged ligaments may simply need time and rest combined with leg support, whereas more serious injuries may require reconstructive surgery. If your vet suspects that the hock is unstable because the ligaments are torn, they will deliberately place the joint under stress by moving it from side to side. This will help the vet to feel whether the ligaments are stable or not. The diagnostic technique of stress X-rays mentioned earlier is similarly useful to determine the extent of ligament damage.
Having concluded treatment, your vet will prescribe the required medication, such as painkillers for the first couple of days, and antibiotics in the case of an open wound. Your vet will then explain to you the findings of the X-rays and/or surgery and offer after-care advice that considers the age and condition of your pet, home environment and recommended levels of activity. Depending on the type of treatment administered, you may be asked to follow up with clinic visits.
In cases such as these, the co-operation and vigilance of the dog owner can make all the difference. Warning signs to look out for include slipping of the bandage or splint, licking or chewing of the bandage (this might indicate discomfort or infection developing beneath), sores at the edges of bandages that suggest irritation of the skin, swelling of the visible parts of the leg on top or below the bandage or splint, or unpleasant odours. With the latter it is particularly important that you seek immediate veterinary attention, as it might mean infection of an open wound. Delayed treatment could mean that the wound becomes septic, leading to loss of the limb from gangrene. Left untreated, sepsis will spread and your pet could die.
Uvetta’s wound was so bad that, for the first few weeks, she had to be brought in every third day to have her old bandage removed, the injured area gently washed with an antiseptic and a new bandage put on. Watching her walking on all four legs again was in no small part thanks to her owners’ determination. Watching her walking without difficulty, I know that Uvetta is a credit to their dedication.
Dr Martin Debattista is a veterinary surgeon.
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