Tendon Contracture and Lymphatic Obstruction, Great Pyrenees

Case Study

Tendon Contracture and Lymphatic Obstruction, Great Pyrenees

  • September 29 2023
  • Case Studies

Author(s): "Baring Boulevard Animal Hospital, Reno, NV"


Signalment:  8 year old, F/S, Great Pyrenees, “Nilla”

History:  Dog missing in NV for 4 days, was found with right front foot caught in steel leg trap.

Initial Assessment and Treatment:  Patient was seen at ER; diagnosed after radiographs with extensive soft tissue damage; ER veterinarian concerned about vascular compromise and warned owner may require surgical debridement.  Discharged on Tramadol (125 mg PO BID/TID as needed for 5 days) and Carproufen (100 mg PO SID for 3 to 5 days); Epsom Salt Soaks for foot recommended.

Initial Presentation:  2 days after ER visit; Patient is non-weight bearing on right front, digits warm, palmar surface a bit moist/effusive with some yellowish skin.  No obvious declared necrotic areas.  Owner advised to continue NSAID, ice treatments and Epsom salt soakings.  If not improving in the next 48 hours, recommended laser therapy.

Recheck Assessment on Day 14:  Painful, non-weight bearing right front paw with pronounced contraction of the carpal joint and marked inflammation with discoloration, edema from the carpus continuing distally including metacarpals and all digits.  Patient self-mutilating low grade (licking the site) and has a lower quality of life.

Laser Therapy:  990 Total Joules to 125 cm2 area (carpus) (8 J/cm2) at 7W Continuous Wave (CW)

Frequency of Laser Treatments:  Daily for 4 treatments, then 48 hours later, then daily for 3 more treatments (8 total treatments).  Slight irregular treatment frequency was due to owner’s scheduling issues.

Recheck Assessment at on Day 22:  “Only mildly evident contracture remaining with inflammation/ swelling being almost nonexistent and the previously circumferential scabbing to the metacarpus was only present on the dorsal aspect at this time.  The patient showed significant and consistent improvement after the initial treatment and continued to show an accelerated rate of palliative and healing responses to laser therapy on a continual basis without any setback or sequellae” – Dr. Hogel

Results:  Final owner’s telephone communication (3/1/2015):  Reports patient has had no setbacks, remains pain free and active.  Patient has resumed historical behaviors which she had been unable to do since prior to the injury event – such as daily roaming the neighborhood about 15 blocks without any sequellae during or afterwards.