Some thoughts on an unusual case…PART 1

A Deep Digital Flexor Tendon (DDFT) injury is a common occurrence in a horse but in a dog?! The dog in question had had short episodes of non-weight bearing lameness, which quickly settled with NSAIDS. The ortho specialist had diagnosed a DDT injury. There was swelling in the plantar lateral aspect of the tarsus which is a tail tale sign. So, what are my thoughts….

· What is the anatomy and Function of DDFT

· Tendon healing takes longer than ligament or muscle

· Tendons need tailored loading

So, being a flexor of the tarsus and digits as well as a stabiliser these are the functions that need to be assessed to determine the current level of function. Was there a mechanism of injury or was this a repetitive strain injury? Are there any compensations? What environmental changes need to be made to prevent aggravation, e.g. stop the dog jumping onto sofas. Is there any PMH that predisposed the injury, e.g. hip dysplasia and has poor gluteal muscle strength?

The DDFT stores elastic energy and recoil releasing that energy causing forward propulsion. This means that end stage rehab will need to include plyometrics but initially isometric loading will help strengthen the tendon without aggravating it. Is the dog’s guardian bought into the rehab programme?

The rehab programme will likely take upwards of 12 weeks to permit sufficient remodelling of the tissues to withstand the forces associated with being an active dog. This is vital to share with the dog’s guardian to ensure that their expectations are realistic. Furthermore, it is important to be mindful of differential diagnoses, such as joint mice, osteosarcoma, stress fracture. Furthermore, if the dog worsened at any point I like to have a discussion with the specialist.

This is some initial thoughts that I thought that I’d share. Part 2 following the assessment!