Understanding Carpal Hyperextension in Dogs: A Canine Physiotherapist's Insight

As a canine physiotherapist, I see many injuries and pathologies in dogs ranging from spinal disease to hip dysplasia to ACL injuries. One injury that tends to alarm doggo owners more so than others is a condition called carpal hyperextension. 
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What is Carpal Hyperextension?
Carpal hyperextension, also known as "dropped wrist" or "down pastern," is a condition that affects a dog's front legs. This occurs when the carpus, which is the equivalent of the human wrist in dogs, extends beyond its normal range, causing instability and discomfort. In simple terms, it's like a dog's wrist bending backward more than it should and the supporting ligaments can become lengthened and stretched.  A normal wrist has straight upright legs while a hyperextended wrist is flatfooted in appearance. 

Causes of Carpal Hyperextension

1. Genetics: Some breeds are more prone to carpal hyperextension due to their genetic predisposition. Breeds like Great Danes, Doberman Pinschers, and Basset Hounds are more commonly affected.
2. Developmental Abnormality: Carpal hyperextension in young dogs is caused as a result of weakened ligaments. It is often seen in large breed puppies such as Great Danes and causes can range from inadequate nutrition to rapid growth however, sometimes no underlying cause is identified. 
3. Trauma or Injury: Accidents, falls, or repetitive stress on the front legs can lead to carpal hyperextension where the ligaments get stretched or torn and is a common cause of carpal hyperextension in dogs. 
4. Overuse: Working dogs or those involved in strenuous activities might develop this condition over time.

Carpal Hyperextenson

Signs and Symptoms
Identifying carpal hyperextension in doggos is the first step towards addressing the issue. Keep an eye out for the following signs:

1. Lameness: Dogs with carpal hyperextension may exhibit a subtle or pronounced limp on one or both front legs depending on the severity of the hyperextension. 
2. Swelling: The affected area can become swollen, warm to the touch, or painful, particularly if acute trauma has caused the instability. 
3. Stiffness: dogs might appear stiff and reluctant to bear weight on the affected leg.
4. Abnormal gait: Dogs may walk with an abnormal walking pattern. Often owners are alarmed at how the carpus 'looks'  and many people describe it as looking ' deformed.' 

Treatment Options
As a canine physiotherapist, my primary goal is to help doggos regain their mobility and comfort. Treatment depends on the severity of the condition but here are some treatment options for carpal hyperextension:

1. Physiotherapy/ non-surgical: Customised physiotherapy exercises and stretches can improve joint stability and muscle strength, helping doggos regain proper carpal alignment.
2. Supportive Bracing: In some cases, specially designed braces can be used to provide additional support to the carpal joint and can be fitted through a veterinarian or canine physiotherapist.  The brace helps support the carpal joint and restores normal function to the stretched ligaments. 
3. Medications: Anti-inflammatory drugs may be prescribed by the treating veterinarian to reduce pain and inflammation.
4. Lifestyle Adjustments: Ensuring that your dog avoids strenuous activities and maintains a healthy weight can aid in their recovery. Avoiding tasks that place undue stress on the carpal joint line jumping down from height and chasing balls repetitively can help to alleviate symptoms. 
5. Surgical Intervention: In severe cases, surgery may be recommended to correct the carpal hyperextension which typically involves fusing the entire carpus (arthrodesis.)

Preventing Carpal Hyperextension
Prevention is always better than cure. To minimise the risk of carpal hyperextension in doggos, consider the following:

1. Regular exercise: Maintain a balanced exercise routine to keep doggos muscles strong and joints healthy. Excessive exercise like chasing and running for balls can place extra stress on the carpal joint and will need to be kept in moderation with all other forms of exercise. 
2. Protect against injuries: Keep an eye on your dog during physical activities and minimise any potential hazards. Check the home for any tripping hazards such as slippery floors, particularly when jumping off surfaces like the couch onto them and if needed,  put an anti-slip mat down. 
3. Weight management: Ensure your dog maintains a healthy weight to reduce excess strain on their joints.

Protecting the wrist joint (carpus) from over use or acute injuries such as jumping or repetitive chasing will help to prevent carpal hyperextension

​Carpal hyperextension can be a challenging condition, but with the right guidance, it's possible to manage and let dogs go on to lead a full and happy life. Remember, early detection and proper treatment can make a world of difference. If you suspect your dog is suffering from carpal hyperextension, don't hesitate to reach out to a canine physiotherapist or veterinarian for assistance.

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