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Carpal Flexural Deformity, aka knuckling over or bowed legs

53K views 51 replies 24 participants last post by  marymouse 
#1 · (Edited)
I have seen several people come to DT looking for help with their pups who have carpal flexural deformity. Often people search for the phrases "knuckling over" or "bowed/bowing legs".

My puppy, Axel, had a significant case of carpal flexural deformity. At least one of his littermates did, too, but not as bad as Axel. I was told several times when it first started that he would just outgrow it and not to worry. But he didn't. He just kept getting worse and worse. I was told if I wanted, I could give him calcium supplements or Vitamin C. My vet said that calcium is an old school way of thinking and can actually be counter-productive. Vitamin C wasn't going to hurt anything if I wanted to give that.

I'll start out by showing a photo from before any signs showed. I already had him at home, and his legs were just fine.



Then 3 weeks later he looked like this:



Here he is at its worst when he was a little over 2 months old:



This is when I found DT and the other littermate who was going through the same thing. The thread for everything we went through is here: http://www.dobermantalk.com/puppy-corner/61357-what-do-about-knuckling-over.html

My vet and I consulted 2 orthopedic specialists and saw a canine physical therapist in addition to numerous regular vets. I researched the bejeezus out of carpal flexural deformity and this is what is working for Axel, who is still healing at 22 weeks but has seen tons of progress.

1. You want to grow your puppy slowly. Get him on a lower protein food, no more than 23-24% crude protein. All dog food packaging will tell you this content. Be sure to verify any treats or snacks you give him is low protein as well.

2. Limit his food to 3 small portions throughout the day. At 14 weeks I was feeding Axel about 2 cups of food in three meals combined. You don't want to feed him so much that you get that swollen puppy belly look. You want to keep him slim. The less weight he has to support with his legs, the better. If you start to see several ribs or the bones on the top of his back start to protrude, then he definitely needs more food. You can also tell if the food is good enough if his coat is smoth and silky.

3. If your home has hard floors such as tile or hardwood floors, buy some cheap nonslip area rugs from Walmart so his paws can grip the floor for better support and strength building.

4. Do stretches on your dog's legs several times a day. Little by little you want to stretch out his legs so they will stand correctly. Take one of his front legs in your hands. Hold it as straight as possible and gently push up on his paws so they are in a position similar to how they would be if he were standing. If they're not stretching all the way now, don't worry, he can get there with diligence.

5. Most definitely get DogLeggs carpal supports for your puppy. They have made all the difference for Axel. His legs kept getting worse and worse until he started wearing these. They require a vet's prescription. Pay for the interior lining and the extra support strap for each leg. They cost me about a total of $120USD. The puppy doesn't have to wear them while he's sleeping, so that's nice. They don't cause sores from chafing, either. Plus you can machine wash them. Carpal Support | DogLeggs Theraputic and Rehabilitative Products

The DogLeggs carpal supports are custom sized to your dog. I sent the company this photo of Axel's legs when he was 10 weeks old to create the custom-made supports:



And here is a photo of him wearing them for the first time less than 2 weeks later:



Here is a photo of him after wearing them for a week:



Here is a photo of him after wearing them for 2 weeks (you can see I added the rug in the kitchen on the tile):



6. Until his legs are mostly standing straight, keep his activity to a minimum. Crate him most of the day, except for potty and food if you have to. This won't last forever, but is necessary for a little while. You might have to put up with some protesting, but it's for his own good. Once his legs are supported or mostly straight, exercise is good for him, but nothing forced, such as taking him for a long walk or run. Let him just play naturally and don't push him to run hard.

Axel is still on his road of healing, but he's seen great improvements. His legs still bend a little bit inward now but he's running and playing just fine. Whenever I know he's going to be active, I still put the supports on his legs.

Here is a photo of him at 4 months:



And here is one a couple weeks later (two weeks ago). This one he is laying down, but you can see there is still a slight bend in his legs.



If anyone ever has questions or concerns about carpal flexural deformity/knuckling over/bowed legs, please comment or PM me. I'm more than willing to share my and Axel's experiences with you in hope that it can help your puppy. If I think of anything else, I'll add it in a comment.

I put this in the Puppy Corner section since this is mostly a condition found in puppies, and this is where most people post asking for help. If a mod wants to move it to the health section, that's fine, too.
 
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#33 ·
So glad that poor guy is doing better.

I have done a fair bit of research on orthopedic disorders and found that calcium is more often the culprit than protein, despite the mass opinion that protein is what we need to stay away from.

Did everyone know that in some breeds, excess calcium is known to cause bowing of the front legs? I found this in some veterinary journals monthly articles and followed up on them and I will try to post some links later on.

Does the OP know what the total calcium level was in the food he was eating early on? It was previously thought that the ratio was the crucial part- that was incorrect, apparently. Now, the latest research shows that the total dietary intake of calcium is what's important.

Here's a pic- not the same exact thing, but a puppy from a repeat breeding of 100% healthy joints...except the only one who was fed 3x more calcium than a large pup should have.:mad:
 

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#36 ·
I did have limited support from the breeder. However, he kept saying to leave him be and it would get better on its own like all the other puppies he'd had that had this problem. He even suggested a calcium supplement, but my vet said no to that. I really believe that Axel's legs would be much more crooked now if I hadn't intervened.
 
#37 ·
That is NOT puppy food. Yeeesh. What was he thinking?! I can't easily find the calcium content, but the calories alone plus fat and protein are pretty insane for a little pup. I don't know what Natural Balance you were using so I can't look that one up either, but it was probably ok, so long as it was intended for large breed puppies.

I wonder if more than one pup had it due to the way he fed them early on!
 
#39 · (Edited)
They certainly look better than before. I would need to see a front view to really see what you are talking about, tho. He certainly looks in excellent condition and like a normal rowdy boy pup.:):):)

It looks to me like the Diamond food has way too much fat, which is a lot of the calories he didn't need. Calcium is probably too much also. Am still looking for that. A mathmatical genius I am not, but betting the carbs in the Extreme Athlete are high seeing as they are slightly less or equal in weight to the chicken meal. The plain "chicken" contains water which once removed places the chicken much lower on the ingredient list.

You can see the fat content of the Orijen LBP food here. Note the fat and carb %.

Orijen
 
#41 ·
Thank you for your dedication and terrific work with Axel. And thank you for putting this thread on DT - it helps people all the time.

His feet are a little easty-westy or toed-out, not pigeon-toed (pigeon-toed toes in). I think he looks fabulous and one would never know he had endured such a difficult problem. I bet he is the most tolerant and gentle dog around, right? That is my experience that those that have trouble as young pups and learn to put up with pain and manipulation are very stable and tolerant.
 
#44 · (Edited)
Axel's littermate who also had this is a female. I later found out that the "breeder" had several pups who experienced this (he failed to mention this to me when I asked about medical conditions in his dogs.) I think it may be more strongly related to genetics than gender. Also he was feeding his brand new pups a 32% protein dog food.[/QUOTE said:
I'm curious, was it a puppy food? Too much calcium can cause this. Too much protein absolutely is to blame, especially for the large to XLg breeds.
I've seen pups go down to 18% protein and do just fine.

You are great for seeking specialists and documenting your success. He looks like a happy boy.

PS: try to get his nails as short as possible to tighten up his feet. In the beginning, you may have to keep the nails a wee longer than "short," in order to let the nail quick recede. But, get on those nails! Even if you have to go to a professional groomer and have them use as Dremmel. It'll cost around $10-$14 and so worth it.
 
#46 ·
Thank you so much for this post. Mina is 8 weeks old and is showing signs of the same problem. It's not too bad yet and it seems like after she plays for a little while with my other dog it looks a little worse. Thanks for all of the tips you've shared! She goes to the vet on Tuesday to get her ears cropped so I will bring it to his attention. I haven't talked to the breeder yet, but I intend on it after this post. Thanks again!

Oh and I just wanted to add that she is on Nutrisource large breed puppy food (chicken).
 
#49 ·
ok I am kinda freaking out a little

My new puppy was suppose to be shipped this weekend, well she developed bowed legs, so the breeder is keeping her longer so she can be perfect for me when she comes. This dog is suppose to be shown? I never had a dog with bowed legs, can someone tell me how this can happen from an exp breeder. Am I making a mistake to take this puppy once her legs are straightened out. Any advice will be appreciated. Please PM mail me I do not want to mention breeder on here.

Mary
 
#50 ·
You've already mentioned the breeder in another thread(s). And even with the best breeders, things don't always go as planned. I think it is good of her to keep the pup a while longer to see if it corrects or not.
 
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#51 ·
It happens, even with long time, reputable breeders. Sometimes it corrects itself on its own, sometimes tweaking the diet does the trick and sometimes it is a permanent issue.

My Lola started to both knuckle over and bow out at about 9-10 weeks of age. I tweeked her diet a bit and it corrected itself in a matter of days.

I also think your breeder is doing the right thing by keeping the puppy until this is resolved.
 
#52 ·
I finally got my puppy,she is no longer show quality but I took her anyway, her one leg is still bowed pretty badly. they have been feeding her purina one, can i switch her to a better food, will that help or do i need get the splints like the original poster. she is 14 weeks. wellness puppy or earthborn or? I want this fixed, i see her leg shaking when she stands. also I need to repost her ears, do I put a brace on them in between, the breeder just said look at you tube but their are quite a few different ways. Mary
 
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